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GONORRHEA 



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SEXUAL DEB 



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By DR. FERDINAND. HERE 




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GONORRHEA 



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SEXUAL DEBILITY 



IN MEN 



— BY- 



DR. FERDINAND HERB 

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AUTHOR OF 



Female Diseases, Their Prevention and Cure; 
The Care-Feeding of the Baby, Etc 



PUBLISHED BY 

THE R & S. PUBL. CO. 

SUPERIOR. - WIS. 






.IBRARYofCX^ 
• wo Copies ftecetv^ 

APR 14 1908 

SOHY 3 U 



COPYRIGHT, 1908 

BT 

FERDINAND HERB 



All Sights Reserved. 



* 

^ 



IN DEEPEST SYMPATHY. 

THIS BOOK IS DEDICATED TO THAT 

MOST UNFORTUNATE PORTION OF PURE WOMANKIND 

WHO HAVE BECOME, AND DAILY ARE BECOMING, THE INNOCENT 

VICTIMS OF THIS LOATHSOME AND DREADFUL DISEASE, 

THE PREY TO THE "WOEFUL IGNORANCE" 

OR "DEPLORABLE LEVITY" 

OF MEN. 



CONTENTS. 



PART I— GONORRHEA. 

CHAPTER 1. 
Historical Introduction. Pages 17 to 18. 

CHAPTER 2. 
Prevention of Venereal Disease in General. Pages 
19 to 24. 

CHAPTER 3. 
Importance of Gonorrhea. Pages 25 to 28. 

CHAPTER 4. 
Importance of Gonorrhea to Men. Pages 29 to 30. 

CHAPTER 5. 
Importance of Gonorrhea to Women. Pages 31 to 45. 

CHAPTER 6. 
Danger to the Offspring. Pages 46 to 47. - 

CHAPTER 7. 
Sterility in Marriage. Pages 48 to 49. 

CHAPTER 8. 
Contagion of Gonorrhea. Pages 50 to 51. 

CHAPTER 9. 
Mode of Infection. Pages 52 to 54. 

CHAPTER 10. 
Not every Discharge a Gonorrhea. Pages 55 to 56. 

CHAPTER 11. 
How and where Gonorrhea is Contracted. Page 57. 



CHAPTER 12. 
How to Prevent Gonorrhea. Pages 58 to 62. 

CHAPTER 13. 
Acute Gonorrhea. Time of Incubation. Symptoms. 
Treatment: Rest, Diet, Local Cleanliness, Cleanliness of 
Hands and Surroundings, Regularity of the Bowels, Ap- 
plication of a Suspensory, Application of Heat. Pages 
63 to 76. 

CHAPTER 14. 

Condition of Urine. Page 77 to 78. 

CHAPTER 15. 
Urinary Antiseptics. Pages 79 to 80. 

CHAPTER 16. 
Treatment of Chordee. Pages 81 to 82. 

CHAPTER 17. 
Sudden Stoppage of Urine. Page 83. 

CHAPTER 18. 

Local Treatment of Gonorrhea. Injections: Care of 

Syringe, Filling of Syringe, How to make Injections, 

Frequency of Injections, Length of Time the Medicine 

should be Retained, Remedies to be Used. Pages 84 to 94. 

CHAPTER 19. 
Irrigation Treatment: Irrigation of the Anterior 
Urethra, Remedies to be Used, How Ofteu to Irrigate, 
Temperature of the Water, Irrigation of Half or Entire 
Urethra. Urethral Suppositories or Crayons. Pages 
96 to 101. 

CHAPTER 20. 
Internal Remedies. Pagfes 102 to 110. 



CHAPTER 21. 
Duration of Simple Gonorrhea. Page 111. 

CHAPTER 22. 
Chronic Gonorrhea. Symptoms: Discharge, Shreds 
and Filaments Course. Treatment: Diet, Local Cleanli- 
ness and Cleanliness of the Hands, Sexual Relations, Lo- 
cal Treatment, Internal Remedies. Pages 112 to 118. 

CHAPTER 23. 
Obstinate Cases. Pages 119 to 123. 



CHAPTER 24. 
Strictures. Causes. Different Kinds of Strictures. 
Number. Location. Form. Why Strictures Develop in one 
Case and not in Another. Sjntnptoms: Discharge, Fre- 
quency of Urination, Change in the Stream, Effects on 
Sexual Capacity and Procreation, Effects on Other Parts 
of the Body. Diagnosis. Treatment: Treatment with 
Sounds, Preparation of the Instrument, Preparation of 
the Patient, Technic of Introduction, Complications 
Caused by Sounding, False Passage, Urethral Fever, In- 
flammation of the Testicles, Size of Sound, Repetition of 
the Treatment, Urinary Antiseptics, Alkalies and Bal- 
samic Remedies, Strictures of Very Small Caliber, Where 
Sounds Should not be Used, Combination Treatment, 
After-Treatment. Treatment with Dilators. Cutting of 
Strictures. Pages 124 to 150. 

CHAPTER 25. 
Inflammation of the Prostate Gland. Acute Inflam- 
mation of the Prostate Gland. Chronic Inflammation of the 
Prostate Gland: Symptoms, Treatment. Pages 151 to 154. 

CHAPTER 26. 
Inflammation of the Testicle. Causes. One Sided or 
Double Inflammation, Prevention. Symptoms. Course and 
Consequences. Treatment: Rest, Cold and Hot Applica- 
tions, Suspensory, Remedies. Pages 155 to 162. 

CHAPTER 27. 
Inflammation of the Bladder. Prevention, Symptoms. 
Treatment in full. Pages 163 to 169. 

CHAPTER 28. 
Inflammation of the Kidneys. Pages 170 to 171. 

CHAPTER 29. 
Gonorrheal Rheumatism. Inflammation of the Heart, 
the Muscles, etc. Pages 172 to 174. 



PART II— SEXUAL DEBILITY. 
Its Causes, Consequences and Treatment. 



CHAPTER 30. 

Self-Abuse or Masturbation. Masturbation in In- 
fancy, Masturbation in Childhood and Youth, Masturba- 
tion in Adult Life. Causes, Consequences, Treatment in 
full. Pages 175 to 185. 



CHAPTER 31. 
Withdrawal and Protracted Coition and their Con- 
sequences. Consequences to Men. Consequences to Wo- 
men. Treatment in full. Pages 186 to 1S9. 

CHAPTER 32. 
Loss of Semen. Causes, Symptoms, Treatment: 
Exercise, Bathing-, Diet, Bed, Regularity of Bowels, Coi- 
tion and Marriage. Suspensorv, Irrigations. Instruments, 
Remedies. Pages 190 to 201. 

CHAPTER 33. 
Impotence (Lost Manhoodi. Causes, Symptoms, 
Treatment: Diet, Water, Massage.. Sexual Relations, 
Marriage, Medicines. Pages 202 to 215. 

CHAPTER 34. 
Sterility: Sterility in Marriage, Percentage of Ster- 
ile Marriages. Causes: No Seminal Fluid, no Sperma- 
tozoa. Who is to blame? Treatment in full. Pages 216 
to 225. 

CHAPTER 35. 
Examination of Urine. Test for Pus. Test for Albu- 
men, Test for Sugar. Pages 226 to 228. 



PREFACE. 



Ignorance is darkness; 
Knowledge is light. 



According to carefully compiled statistics, 75 
to 95 per cent, of the male population of the larger 
cities have suffered, or still suffer, from sexual dis- 
ease, gonorrhea or syphilis. This appalling fact 
has of late aroused most energetic efforts to check 
this rampant evil. Much has been said and writ- 
ten on the subject, medical men have gathered for 
discussion, and preachers and teachers have been 
called into consultation to devise some measure of 
relief. All concurred that so long as the present 
dense ignorance in regard to the very elements of 
sexual matters prevails; so long as an ill-timed 
prudery withholds knowledge and hides the vice 
from view, improvement must remain impossible. 
"Enlighten the public" became, therefore, the 
ringing slogan. 

Opinions have differed, and still differ today, 
as to how this end shall be attained. Public meet- 
ings have been held, teachers have taught their 
pupils, preachers have preached from the pulpit, 
thousands upon thousands of dollars have been 



12 GONORRHEA AND SEXUAL DEBILITY 

expended in these and similar laudable efforts; 
but little concrete good has been accomplished. 
And this largely because that very element which 
needs enlightenment most could not be reached; 
the element which does not care to go to public 
meetings, which cannot be impressed with the 
scanty and rather theoretical knowledge imparted 
by the carefully worded warnings of preachers 
and teachers. 

Besides this concerted action, some single 
handed efforts have been made to reach the covet- 
ed goal. A number of books on sexual matters 
have been published. Some of them are good and 
deserving; but who in the tenements will read 
them? Very few; for they are written for the se- 
lect, the educated. The book that can success- 
fully meet the issue and get results must, first of 
all, get the attention of the masses. 

To accomplish this end, it must not only re- 
veal to the people the dire and ruinous conse- 
quences of sexual disease, but also impart practi- 
cal and useful knowledge, readily applicable to 
the given case. In other words, it must give the 
people what they want, namely: Prescriptions, 
with instructions how to use them intelligently. 
Thus induced, the public will buy the book and 
read it. Then, the audience being secured, they 
can be taught the much needed lesson. 

There, no doubt, are those who disapprove. 
But giving prescriptions and detailed instructions 
for self -treatment seems to afford the only practi- 
cal means to strike off the fetters from that great 
throng of sexual sufferers which at present is 
hopelessly bleeding in the clutches of unscrupul- 



BY DR. FERDINAND HERB. 13 

ous manufacturers of patent medicines, so called 
" Medical Institutes," " Progressive Medical As- 
sociations," "Advertising Specialists," and— we 
are sorry, but in duty bound, to say— of that great 
part of the medical profession which still today 
sadly underestimates the seriousness and far- 
reaching consequences of sexual disease. These 
medical men are, indeed, one of the most serious 
obstacles in the path of progress. We cannot 
decry with terms sufficiently strong those licensed 
practitioners who share with, and confirm, the 
public in its belief that "gonorrhea is but a trifling 
matter." To detract from the seriousness of this 
drsease by those who are taken as the undisputed 
authorities means upholding frivolous careless- 
ness and placing a price upon the ruin of the 
family. 

We do not stand alone in these statements, 
but are fully borne out by others, as for instance, 
Prince A. Morrow, the best known American au- 
thority on the social effects of venereal disease. 
In a paper read before the New York State Medi- 
cal Association, May 15th, 1905, he says: 

' ' I will venture the statement that there is no 
class of diseases in any department of medicine 
which in tlje past has been so neglected, misman- 
aged or received such routine and unscientific 
treatment as the venereal class. Many physi- 
cians still look upon gonorrhea as a trivial affec- 
tion, and their entire armamentarium consists of 
a glass syringe and half a dozen or more formulae 
for injections. ' ' 

Exaggerations have beea carefully avoided 
and facts stated only as thoroughly approved by 



14 GONORRHEA AND SEXUAL DEBILITY 

the majority of authorities. Many of their perti- 
nent statements have been cited verbatim in veri- 
fication. 

All illustrations are given in outlines only in 
order to avoid all possible objection on the ground 
of obscenity or vulgarity. 

FERDINAND HERB, M. D. 



PART I. 



GONORRHEA. 



BY DR. FERDINAND HERB. 17 



CHAPTER I. 



HISTORICAL INTRODUCTION. 

Diseases of the sexual organs are as old as our 
traditions. We find them mentioned in both the 
Old and the New Testament. The savants of the 
Greeks and Romans allude to them. It is, how- 
ever, not until the middle ages, the fifteenth and 
sixteenth centuries, that we meet in history with 
the first half-way accurate description of venereal 
disease. Prudery and a kind of religious awe de- 
terred from fuller investigation. It seemed dese^ 
oration to lift the veil from this festering sore on 
the body of mankind. 

For this reason, little or nothing was definite- 
ly known as to the nature, origin and mode of 
transmission of these diseases until within com- 
paratively recent years. Up to the beginning of 
the nineteenth century, the identity of all venereal 
diseases, that is, of Gonorrhea, Soft Chancre and 
Syphilis, was universally accepted. 

A change in this condition of affairs was 
brought about when Philippe Ricord, of France, 
began his extensive investigations in the hospital 
of Paris. He was soon able to prove conclusively 
that Syphilis and Gonorrhea are two entirely dif- 
ferent diseases, caused by wholly different con- 
tagions. 



18 GONORRHEA AND SEXUAL DEBILITY 

This was the first great step in the right di- 
rection. Even this great master, however, con- 
tinued to class all venereal sores in the same cate- 
gory and confused Soft and Hard Chancres as one 
and the same ailment. 

The separation of these two last named dis- 
eases was reserved to Bassereau, a pupil of Kicord, 
who advanced the now universally accepted doc- 
trine that Soft and Hard Chancres are also two en- 
tirely different lesions, denning the first as purely 
local and comparatively harmless, the second as 
the first stage of that dreaded constitutional 
malady, Syphilis. 

Thus, we arrive at the point on which science 
stands today, namely, that Gonorrhea, Soft 
Chancre and Syphilis are three distinct diseases, 
differing from each other respecting their cause- 
origin and clinical manifestations. 



BY DR. FERDINAND HERB. 19 



CHAPTEE II. 



PREVENTION OF VENEREAL DISEASE IN GENERAL. 

The prevention of venereal disease in general 
may, at this point, receive brief attention. 

A man with clear vision will in broad day- 
light, no doubt, avoid obstacles over which, when 
blindfolded or in deep, impenetrable darkness, he 
may easily stumble and fall. 

So it is with the prevention of all disease and 
in particular of sexual disease. Ignorance is the 
darkness under the protection of which disease 
and vice flourish and spread. With knowledge 
comes that light which makes visible, and enables 
us to avoid, those alluring but dangerous, bottom- 
less pitfalls of sexual temptation which beset the 
path of the unwary wanderer through life. 

Knowledge, therefore, is the first and most 
essential requisite for an effective prevention. 
This means, however, not only the knowledge of 
the few, the educated, but knowledge disseminated 
generally among the masses, as to the dire, ruin- 
ous consequences which ruthlessly follow in the 
wake of venereal disease. 



20 GONORRHEA AND SEXUAL DEBILITY 

"It is the experience of all medical men"— 
says Prince A. Morrow ( Journal American Medi- 
cal Association Vol. 44 Page 676)— "that igno- 
rance is responsible for a large proportion of in- 
fections in the young, and that enlightenment, 
which would engender a wholesome fear of these 
diseases, would prevent thousands of them from 
exposure." 

"This education would not only serve as a 
preservative against exposure to infection, but it 
would constitute the most valuable prophylactic 
measure against its introduction into marriage. 
The vast majority of men, who carry disease and 
death into their families from uncured venereal 
diseases, do so ignorantly. A general diffusion of 
knowledge regarding the nature and danger of 
these diseases, the duration of their contagious 
activity, and the terrible consequences to their 
wives and children, would be largely instrumental 
in preventing these social crimes." 

Enlightenment once diffused, it becomes easi- 
er to dispose of the second important subject, that 
is, our attitude towards prostitution. We may, or 
may not, concede that prostitution is necessary; the 
fact remains that it has existed since the day the 
human race sprang into existence and will con- 
tinue to exist so long as human beings inhabit this 
globe. No penalty, no fine, no imprisonment, not 
even the death sentence imposed by some primi- 
tive races, has been able to suppress this so-called 
"vice." It is, after all, a necessary evil. Much, 
indeed, could be said in favor of Lecky, the Eng- 
lish moralist, when he asserts that the prostitute, 
while the supreme type of vice, is ultimately the 



BY DR. FERDINAND HERB. 21 

most efficient guardian of virtue. And when in 
his "European Morals' ' he continues: "But for 
her, happy homes would be polluted, abortion and 
infanticide would increase, unnatural and most 
harmful practices would abound/ ' he strikes a 
concordant note in the heart of many a broad- 
minded student of human society. It is, indeed, a 
fair-minded conception of prostitution, lofty and 
worthy of the great man; a conception repeatedly 
borne out by practical experience. A forcible illus- 
tration we find in the history of Frankfort, Ger- 
many. An effort was made there in the 18th cen- 
tury to suppress prostitution by closing the bawdy 
houses, punishing the offenders with heavy penal- 
ties and expulsion from the city, etc. This course 
led to such a marked demoralization of the entire 
population that the better element and the police 
could cope no longer with the situation, and after 
numerous, fruitless other attempts at redemption 
the re-opening of the resorts referred to was again 
permitted as the only salvation (Hanauer: Die 
Geschichte der Prostitution in Frankfurt A. M.). 
Why, then, shut our eyes against this "neces- 
sary evil?" Is it not better to look it squarely in 
the face and grapple with the problem in an intel- 
ligent way? Is it not better to minimize its dan- 
gers than to try to dispute its very existence? 
And these dangers can be greatly minimized, in- 
deed, by a strict and intelligent control over the 
prostitutes. But the control should not be a pri- 
vate one. To be effective, it must be a municipal 
or state control. There exists now in most of 
these houses a sham-control. A private physi- 
cian, selected and hired by the keeper of the house, 



22 GONORRHEA AND SEXUAL DEBILITY 

examines the inmates weekly and duly hands them 
their "Clean Bill of Health" in the form of a card, 
signed by him, to the effect that Miss So and So 
has been examined on this or that day and found 
to have no venereal disease. These statements 
are universally, by the police and the public, taken 
as correct. But what does the farce amount to? 
If the physician would do his duty and announce 
those sick who really are sick, he would lose his 
job. But since they are in the business to make 
money, most of those who do this unsavory work 
suppress their qualms of conscience and pocket 
the fee rather than to be the true protectors of the 
public. These sham examinations serve to throw 
sand into the eyes of a confiding public, but should 
lull no one into a seductive feeling of security. 
The real fact, as forcibly demonstrated by statis- 
tics, is that 80 to 90 per cent, of all prostitutes suf- 
fer either from gonorrhea or syphilis. 

European countries are dealing differently 
with this perplexing problem. Physicians with a 
fixed salary, absolutely uninfluenced by the results 
of their findings, make an independent and rigid 
examination two to three times a week of all those 
who are under police control, that is to say, not 
only of the inmates of bawdy houses, but also of 
those straying prostitutes who ply their trade in 
separate, private quarters. Xone of them is 
exempt from these examinations, and a heavy fine 
or imprisonment is imposed upon those who fail 
to present themselves at the proper time. Those 
found sick are immediately removed to the hospi- 
tal and kept there until cured. 

The main objection raised against this way of 



BY DR. FERDINAND HERB. 23 

dealing with the problem is the contention that 
government control means government sanction. 
Such an assertion, however, is unjust and not 
founded on fact. 

We have dwelt upon these matters at some 
length as legal measures of the kind proposed 
cannot be enacted, much less adequately enforced, 
without the sentiment of an educated public be- 
hind them. 

A few words more to you, father or mother or 
brother of a marriageable girl! It devolves upon 
you to protect the confiding, innocent being from 
that dreadful fate which annually befalls many 
thousands of brides. Healthy and blooming they 
enter the flowery gates of wedlock with a charm- 
ing smile, but soon turn pale in lingering death, 
stung by that venomous viper, called: Gonococ- 
cus. There is no need of such terrible sacrifices on 
the altar of ' ' Ignorance ' ' as we show in the follow- 
ing pages. They can and should be forestalled. 
And it is your duty, father, mother and brother, 
to do it. The task is easy. No national nor state 
law need support, nor will hinder you to ask for a 
" Clean Bill of Health " from the future groom of 
your daughter or sister. Do not quail because 
you know him from boyhood as honest and up- 
right; do not quail because he is your friend; do 
not quail because he looks and acts innocently,— 
ask for the Clean Bill of Health and ask it to be 
given by your own physician and not his, by a 
physician whom you know to be honest, serious, 
conscientious, incorruptible, and not by one of 
those frivolous and careless medical practitioners 
who consider gonorrhea but "a little dose." 



24 GONORRHEA AND SEXUAL DEBILITY 

What national and state legislatures failed to do, 
do yourself individually: Protect the unwary 
bride against the murderous onslaught of 
gonorrhea. 




BY DR. FERDINAND HERB. 25 



GHAPTEE III. 



IMPORTANCE OF GONORRHEA. 

The importance of gonorrhea can hardly be 
overestimated, but it is generally sadly underesti- 
mated. "It's only a little dose," says the unsus- 
pecting patient. "It's only a little dose," repeats 
the ignorant or conscienceless physician or quack. 

Let us see what those who KNOW say on the 
subject. 

"Gonorrhea, often considered proper subject 
for jest and ridicule, fills our institutions of the 
blind with its victims and brings to the operating 
table of the gynecologist the largest proportion of 
his patients, the innocent sufferer from the * ' indis- 
cretion" and ignorance of youth. The effect of 
this festering mass of disease on the future wel- 
fare of our race is more than a subject for specula- 
tion. Its destructiveness has been observed in the 
past, and there is reason to believe that it is even 
now threatening that enormous vitality which has 
given supremacy to the Anglo-Saxon people. ' ' 
So says the editor of the Journal _pf the American 
Medical Association, the most influential medical 
paper in the United States. See Vol. 47, page 
512. 

Prince A. Morrow, Emeritus Professor of 



26 GONORRHEA AND SEXUAL DEBILITY 

Genito -Urinary Diseases in the University of New 
York, in a paper read before the New York State 
Medical Association, May 15th, 1905, expresses 
himself thus: 

"The pathological liabilities of gonococcus 
infection are scarcely less formidable. Passing 
by the local inflammations, the articular and sys- 
temic complications in the male, let ns consider 
only those results of infection which go to make up 
the saddest chapter in the martyrology of married 
women. The undeniable and scientifically demon- 
strated danger of gonococcus infection in women 
is that it causes 80 per cent, of all deaths from in- 
flammatory diseases peculiar to women, practi- 
cally all the pus tubes, more than 75 per cent, of 
suppurative pelvic inflammations and 50 per cent, 
of all gynecological operations performed by the 
surgeons, to say nothing of the large number of 
women who drag out a miserable existence of 
invalidism. ' ' 

"Its effects upon pregnancy and conceptional 
capacity are most disastrous; 20 to 30 per cent, of 
gonorrheally infected women abort : from 45 to 50 
per cent, are rendered irrevocably sterile. ' ' 

1 ' The social dangers following gonococcus in- 
fection in women are not limited to its effects upon 
her health and productive energy, but are mani- 
fested further in the infective risks to her off- 
spring; 80 per cent, of the blindness of the new- 
born and 20 per cent, of this terrible affliction 
from all causes is due to the gonococcus infection, 
as well as the large proportion of vulvovaginitis 
and joint affections occurring in children." 

Joseph Taber Johnson. M. D., of Washington. 



BY DR. FERDINAND HERB. 27 



D. C, in a paper read before the American Medi- 
cal Association, June, 1904, states as follows: 

* ' The effect of gonorrhea on the female gener- 
ative organs has been so destructive that no suc- 
cessful contradiction is feared when the belief is 
expressed that no disease in modern times has 
caused so much indirect mortality, mutilation and 
suffering, both mental and physical, as gonor- 
rhea." And later: 

" It is estimated that from 40,000 to 50,000 
prostitutes die annually. While much of this mor- 
tality may be due to the results of dissipation and 
natural causes, at least 30 per cent, of this mortal- 
ity is due to the direct effects of gonorrhea. ' ' 

"It is estimated 110,000 deaths occur annually 
from tuberculosis in our country, 107,000 from 
pneumonia and 43,000 from typhoid fever. While 
there are no statistical reports of investigations of 
the mortality due to the infections and ravages of 
gonorrhea on the female generative organs, I have 
little doubt, if it can be ascertained, that the race 
suicide arising, directly or indirectly, from this 
disease would equal the mortality of any of these 
three diseases mentioned, and I am not sure that 
it would them all combined; if we take into consid- 
eration the depopulation caused by the one-child 
sterility and also the absolute sterility produced 
by gonorrheal inflammation of the uterus and its 
appendages." 

In the same vein speaks Professor Janet of 
Paris, the greatest living French authority on 
gonorrhea, and one of the greatest of all nations, 
when he says: "Gonorrhea with tuberculosis, 



28 GONORRHEA AND SEXUAL DEBILITY 

perhaps more than tuberculosis, is the great pest 
of our age." 

These quotations may suffice. No further 
comment is required to show that these authorities 
do not consider gonorrhea "a little dose," but vie 
with each other in their expressions of the serious- 
ness and gravity of the affliction. 

The following pages tell more of this woeful 
tale. 



BY DR. FERDINAND HERB. 29 



CHAPTER IV. 



IMPORTANCE OF GONORRHEA TO MEN. 

Statistics compiled from hospitals and private 
sources show that the greater part of the male 
population of the larger cities at one time or 
another had, or still has, gonorrhea; that a great 
percentage of those infected contract more or less 
serious complications; and that a part of these 
latter result in irreparable injuries. 

The loss of time, the annoyance from the dis- 
charge, the smarting and burning sensation dur- 
ing urination, the suffering from painful erections 
(chordee), etc, are but trifles in comparison with 
the complicating inflammations of the prostate 
gland, the seminal ducts, the testicles, etc. These 
latter are apt to bring home to some of the patients 
the realization that gonorrhea is something more 
than a trifling matter. But even the most 
thoughtless and superficial person is roused to this 
truth if inflammation of the bladder supervenes, 
and especially if the gonococcus succeeds in reach- 
ing the kidneys, causing Bright 's disease, dropsy, 
etc. Then the danger to life begins and too late 
it dawns upon the sufferer that the "little dose" 



30 GONORRHEA AND SEXUAL DEBILITY 

is after all a most dreadful disease. Still more will 
lie appreciate the seriousness of the " little dose" 
when he hears, or learns by experience, that the 
contagion of gonorrhea not only spreads by conti- 
nuity to all the neighboring organs, enumerated 
above, but may also enter the circulating blood 
and attack almost any part of the body,— as, for 
instance, the joints. Many a cripple, limping 
helplessly on crutch or cane, unable to work and 
earn a living, an object of public pity, is a warning 
example of what one may get from "gonorrheal 
rheumatism, ' ' the direct progeny of the "little 
dose." Most dangerous is the contagion's attack 
upon the heart. No remedy will ever cure its 
consequences. If the valves in the interior of this 
organ are impaired, the lesion is permanent and 
another number is added to the long list of those 
lifelong sufferers who are paying a fearful penalty 
for a brief moment of passing pleasure. 

The foregoing occurrences are by no means 
rare. Although the laity, unaware of the far- 
reaching consequences of gonorrhea, will hardly 
ever suspect the connection of a stiffened leg or 
arm, or a damaged heart, with the imperfectly 
cured gonorrhea, or a seemingly harmless gleet, 
the well informed cannot fail to find the missing 
link. 



BY DR. FERDINAND HERB. 31 



CHAPTER V. 



IMPORTANCE OF GONORRHEA TO WOMEN. 

The following lines are not intended as a 
treatise on female diseases, but are incorporated 
with a view to more thoroughly impress upon the 
mind of the uninformed and frivolous the enor- 
mous potential influence of the ' l little dose ' ' upon 
the happiness of the home, the welfare of the fam- 
ily, the future of the offspring. 

May they be a solemn object lesson and for- 
ever restrain those concerned from making light 
of a disease which has in its wake such a train of 
physical woes and mental anguish. How much 
sorrow, discontent, pain, misery and desperation 
would thus be averted; how many deaths be pre- 
vented ; how enormous would be the benefit to the 
individual, the community, the state! 

Not until within comparatively recent years 
did the realization of the importance of gonorrhea 
of the female organs dawn upon the more intelli- 
gent members of the medical profession. Noeg- 
gerath of New York was one of the first in the 
field. Extensive investigations convinced him 
that the majority of all ailments peculiar to 



32 GONORRHEA AND SEXUAL DEBILITY 

women were caused by gonorrhea. His essay on 
this subject, published in 1872, startled the world 
and stirred the medical fraternity into very active 
research for verifying or rejecting his assertion. 
The further investigation proceeded, the more 
substantial was found to be the truth of what, at 
first, seemed to be a vagary of a pessimistic mind. 
Indeed, of late it has been demonstrated that even 
a greater percentage of women is invalid through 
gonorrhea than this great master divined. 

It seems almost impossible to believe, but it is 
borne out by the most careful and painstaking in- 
vestigations, that of all operations made for in- 
flammatory conditions of the inner female organs, 
the great majority is necessitated by gonorrheal 
infection. Professor Pozzi, the great French sur- 
geon, stated that, according to his observations, 
almost all of the accumulations of pus in the Fal- 
lopian tubes, which had to be removed by abdom- 
inal section, had their origin in gonorrheal infec- 
tion. Dr. Verchin, another celebrated surgeon, 
came to the same conclusion. 

In 1901, the American Medical Association 
appointed a committee for the collection of statis- 
tics bearing on gonorrhea. The question: ""What 
is the proportion of pelvic inflammations coming 
under your care which were attributable to gonor- 
rheal infection? " was sent to all prominent gyne- 
cologists in the United States and abroad. Thirty- 
five replied. A few may be cited in excerpt: 

Humiston attributed 90 per cent, of all inflam- 
matory diseases of the female organs to gonorrhea; 
Dr. Price stated that in over one thousand abdom- 
inal sections for pelvic inflammation 95 per cent. 



BY DR. FERDINAND HERB. "", 33 

were attributable to gonorrhea; Pozzi and Fre- 
deric allowed only 75 per cent. Others give still 
less; but all agree that the percentage of cases of 
inflammatory conditions of the female sexual 
organs, attributable to the invasion of the gono- 
coccus of JNTeisser, is enormous. It is found great- 
er, the more carefully and conscientiously every 
case is studied. " These statistics"— says Prince 
A. Morrow— " be it understood, give no accurate 
indication of the prevalence of inflammatory dis- 
ease of the female generative organs due to 
gonorrhea, as the percentage is for the most part 
based on cases requiring operative interference. 
They take no cognizance of the large number of in- 
fected women who for various reasons are not sub- 
jected to operation and continue under the care of 
the family physician, dragging out a miserable ex- 
istence of semi-invalidism, subject to painful and 
difficult menstruation, no longer able to walk 
freely, condemned to pass their days of suffering 
in a reclining position, and after years, it may be,, 
of this suffering, worn out and desperate, apply to 
the surgeon, who, at the price of the sacrifice of 
the uterus, tubes, and ovaries, renders their exist- 
ence possible in making them castrated women." 

The form in which gonorrhea appears in the 
female differs according to the virulence and the 
number of microbes implanted into the sexual 
organs. The greater the virulence, and the great- 
er the number of gonococci, the more violent will 
be the symptoms. 

We may, for a better understanding, distin- 
guish three forms: 

First, the acute form. Two to three days 



34 GONORRHEA AND SEXUAL DEBILITY 

after infection the outer parts begin to swell, be- 
come reddened and tender to the touch. Urina- 
tion grows painful. A thick, greenish pus exudes 
from the vagina. It covers the outer parts and 
produces stiff spots in the underwear. Walking 
becomes distressful. After a few weeks or a 
month, pains in the back, the sides and in the re- 
gion of the bladder appear. Sexual congress is 
extremely annoying and often impossible. Men- 
struation, up to this time regular and without dis- 
comfort, turns painful and is accompanied by 
more or less violent cramps and sharp cutting sen- 
sations. The blood, formerly fluid and bright, is 
now dark, intermixed with pus and often lumpy 
and liverlike. 

Even if proper treatment is instituted in time 
and the progress of the disease can be stopjjed, 
improvement is slow. Urination gradually be- 
comes less painful; the discharge gets whiter and 
thinner and less in quantity; the swelling of the 
outer parts subsides and the monthly period grows 
less distressing, but seldom is entirely free from 
pain until months or years have passed, or until 
the change of life brings an end to menstruation. 

If, however, the disease progresses and the 
contagion finds opportunity to invade the Fal- 
lopian tubes and reach the ovaries and abdominal 
cavity, most lamentable conditions arise. The 
suffering is enormous. For weeks and months the 
most excruciating pains prevail. If recovery en- 
sues, it is slow, very slow, and frequently inter- 
rupted by relapses. In many cases it remains im- 
possible until serious operations have been re- 
sorted to. 



BY DR. FERDINAND HERB. 35 

Jullien, a prominent French specialist in 
female diseases, gives in his recent work ' i Gonor- 
rhea and! Marriage, ' ' as cited by Morrow, a vivid, 
but true, picture of the happenings of a wedding 
trip, typical of many like cases, on which pure, 
innocent women are permanently ruined by the in- 
fection with gonorrhea. After calling attention 
to the fact that in many instances the young hus- 
band, following the advice of his ignorant or care- 
less physician, is wholly unconscious of the great 
danger to his young wife which lurks in the pres- 
ence of his uncured chronic gonorrhea or gleet, he 
proceeds: 

"Towards the third day after the first ap- 
proach, the gonorrhea shows itself, the symptoms 
being the more manifest because they are compli- 
cated by the injuries of the defloration. The 
young woman hardly dares to complain, still less 
to demand an examination. Her husband, how- 
ever, insists, with an ardor not difficult to under- 
stand, in continuing to exercise his rights, and 
every day he sows and reaps the evil seed which is 
developing. When she complains of an itching, 
burning sensation, both agree in attributing it to 
the defloration, and it is only when her sufferings 
and anxiety reach a high pitch, and she refuses to 
let her husband embrace her, that he in his turn 
begins to grow anxious and wants to know some- 
thing about it. He looks and naturally sees every- 
thing, and understands nothing. The couple are 
on their wedding tour, perhaps in a foreign city. 
A druggist is consulted and gives a bottle of solu- 
tion of boric acid or some other stuff equally in- 
effective; the inflammation increases. The victim 



36 GONORRHEA AND SEXUAL DEBILITY 

is driven nearly wild by her sufferings and by be- 
ing repeatedly told that it is nothing— " that it is 
always like this at first/ ' Can one imagine the 
distress of the innocent girl? She is young, almost 
a child, and it is the first time she has ever left her 
parents. She is with a man whom very often she 
hardly knows, and when she has submissively sac- 
rificed to him all her sentiments of natural or 
acquired modesty she feels herself a prey to a 
malady as mysterious as it is painful and which 
makes her blush as much as it makes her suffer. 
A doctor is at last called in to examine her. He 
finds the mucous surfaces red and turgid, the folds 
swollen, the torn and bleeding remains of the hy- 
men, and all bathed in pus. The picture is well 
known to all those doctors who practice in places 
resorted to on wedding tours, and for my part I 
have seen it often enough in Paris. ' ' 

As illustrations of the acute type of infection 
let us cite the following actual cases: The first 
one is related by Morrow from a report of Dr. Gar- 
rigues, who says: "I knew a girl in perfect 
health, of great beauty, of Junoesque proportions, 
combining muscular strength with regularity of 
features and graceful movements, possessing a 
most amiable disposition— in brief, a paragon of a 
wife to make a husband happy. She married a 
nice young man in good business. It was a mar- 
riage based upon mutual affection and held out 
every prospect of a long and happy union. A 
week after her marriage she came to me with an 
abscess in one of Bartholini's glands and a profuse 
discharge from the uterus. She was under treat- 
ment for months. The abscess was opened and 



BY DR. FERDINAND HERB. 37 

drained; the uterus was washed out daily with 
powerful germicides, curetted, and drained, and 
finally treated with electricity. During her men- 
strual period she was seized with violent pain in 
the lower part of the abdomen and had a tempera- 
ture of 105° F. and a pulse of 140. Two days later 
a swelling appeared in the pouch of Douglas. In a 
few more days the swelling appeared three inches 
above the symphysis. An incision in the vagina 
gave exit to a large amount of pus. The peritoni- 
tic infection continued to spread, and laparatomy 
was performed. Some pus foci were opened, but 
the appendages were so embedded in a mass 
formed by the uterus, the intestines, and newly- 
formed tissue that their removal was found im- 
possible. Finally she died. 

In many similar cases the patients recovered 
for the time being, but went on leading a life of 
invalidism interrupted by more acute attacks of 
peritonitis. Some get well after having their 
ovaries and tubes removed. This, then, is what 
awaits these poor women— discharges, inflamma- 
tions, a life full of suffering, capital operations, or 
death.' ' 

Then, Morrow, continuing, relates one of his 
own cases, thus: 

"A case which came under the author's obser- 
vation some years ago may be cited as illustrating 
the foudroyante character of gonococcic infection 
characterized by rapid invasion of the annexial 
organs. A young man whom I had treated sev- 
eral years previously for syphilis and discharged 
cured, came to me four years later, stating that he 
was to be married in a month, and wished to know 



38 GONORRHEA AND SEXUAL DEBILITY 

whether there was any danger of infecting his 
wife or contaminating his children with syphilis. 
As he had had a thorough treatment and a long- 
exemption from any accident, he was assured that 
he could marry with safety. 

"Just as he was leaving he remarked :_ "Oh, 
by the way, I have had a little gleety discharge for 
three or four years ! I suppose that will make no 
difference. Examination showed that he had a 
couple of strictures, with abundant filaments in 
the urine containing gonococci. Upon my pro- 
testing to him that marriage in his present condi- 
tion was impossible, he insisted that it must go on, 
that all arrangements were made, that the mar- 
riage could not be postponed. It was then ex- 
plained to him fully the probable and almost cer- 
tain results of infection of his wife, with its ser- 
ious consequences: but it was evident that these 
statements were received with downright disbe- 
lief. He assured me that he had had frequent in- 
tercourse with women and knew that they had not 
been infected by him. He was deaf to expostula- 
tions and protested, and the only concession that 
could be procured from him was that he would 
use a protective and begin an energetic treatment 
as soon as possible after his marriage. The mar- 
riage took place at the time appointed. 

"A few weeks later he sent for me in great 
haste, saying that his wife was suffering horrible 
pain. Upon my visit I found a beautiful woman 
doubled up with peritonitis, with a profuse puru- 
lent discharge from the urethra, neck of the 
uterus, and evidences of purulent salpingitis. 
She was desperately ill for some two or three 



BY DR. FERDINAND HERB. 39 

weeks, and then got better. At his express insist- 
ence, she remained under my care for nearly a 
year. During that period she was an invalid, 
scarcely able to walk, spending most of the time on 
a sofa, and with each menstrual period was a re- 
current attack of suppurative inflammation of the 
annexa. He was finally persuaded to consult a 
gynecologist, but as both he and his wife were anx- 
ious to have children an operation was deferred. 
She was a confirmed invalid for three years, and 
finally had her ovaries removed. She is now in 
miserable health, and will probably remain a life- 
long invalid." 

"Now, these cases are drawn from life. 
Such histories are common, so exceedingly com- 
mon that every physician of experience meets with 
them in practice. The experience of all gynecol- 
ogists is concurrent in the conclusion that infec- 
tion of the wife by latent gonorrhea in the husband 
is a most prolific source of illness in married 
women, often leading to invalidism, unsexing, or 
death.' ' 

So much for cited cases. Some more, seen by 
ourselves, will be given in later chapters of this 
book. 

Second, subacute form. The subacute form 
presents itself in about the same manner, but is 
milder in all its manifestations. The pains are 
less, the discharge less conspicuous, the monthly 
period less distressing, and a greater tendency to 
recovery exists. The end is about the same: mis- 
ery and invalidism. 

Third, chronic form. This is the form most 
frequently found. It originates usually from the 



40 GONORRHEA A.ND SEXUAL DEBILITY 

little gleety discharge which is so contemptuously 
disregarded by the public at large. Importance 
is no longer attached to the little drop which ap- 
pears occasionally in the morning. It seems so 
perfectly harmless, as it makes no pain or 
trouble. Why, therefore, hesitate to marry; isn't 
it rather an old, familiar friend? 

But the gonorrheal contagion, furnished by 
many of those old and chronic cases, though atten- 
uated in its virulence, is capable of rejuvenation. 
Lodged in the female organs, in the urethra or the 
neck of the womb, it lurks patiently until more 
favorable conditions allow it to regain its former 
strength and become more aggressive. The little 
discharge, the slight burning it causes, is attribut- 
ed to a cold or so and soon forgotten, as it grad- 
ually passes away. Menstruation, however, re- 
mains in most instances, not in all, more or less 
painful. So it may, and very often does, happen 
that neither husband nor wife are aware of the 
imminent danger. 

Serious complications develop gradually or 
suddenly, according to circumstances. 

In the first instance, the discharge, whitish 
and slimy in character, remains stationary. It is 
more profuse and purulent just before and after 
the monthly. The periods become abundant in 
the course of time, with steadily increasing pain. 
Aches of all kinds and descriptions make their ap- 
pearance. They are less in the intervals between 
the flows, more during their time. Bearing down 
feeling, pain in the back, in the sides, radiating 
down the legs and up between the shoulder blades, 
headache, nervousness, etc., etc., make life mis- 



BY DR. FERDINAND HERB. 



erable and weary. It is in such instances that 
friends and neighbors come to the conclusion that 
* ' married life does not agree with her. ' ' But it is 
not married life, it is that unfortunate and calam- 
itous addition to married life, gonorrheal infec- 
tion, which does not agree with her. 

The cases are too common to cite instances. 
Look around, reader, in your own family, among 
your friends, acquaintances and neighbors. You 
cannot fail to find them. Being ailing all the 
time, having one attack of inflammation of the 
female organs after another, being under the doc- 
tor 's care permanently, having the womb scraped 
a number of times, being cut and mutilated on the 
operating table, having the ovaries, Fallopian 
tubes, the womb removed, etc.— these are the ear- 
marks to look for. 

If, therefore, a man who married a healthy, 
robust girl, with normal, painless menstruation, 
sees his wife wither away from constant pain, ex- 
hibiting the above mentioned symptoms, he must 
not, as is frequently done, complain that he has 
nothing but troubles since he married, and that his 
wife spends all he can earn and more to doctors 
and druggists. He should first look back and ex- 
amine his own record as to sexual diseases. Per- 
haps, he still has that little, ominous drop, or the 
lips of the urethra stick together in the morning, 
or some other sign of chronic gonorrhea (see 
later). The cognizance that he himself is to 
blame for all the misery will tend to make him 
kindlier and more ready to bear his self-created 
fate with less disgust and more respect for the 
innocent and unfortunate sufferer. 



42 



GONORRHEA AND SEXUAL DEBILITY 



For a better understanding, we have brought 
to view in the following figures such changes of 
the female sexual organs, wrought by gonorrhea, 
as are frequently alluded to in the foregoing and 
following pages. They are reproductions of con- 
ditions actually found in diseased women. 

The progress of chronic gonorrhea, however, 
is not always gradual and slow. The gono coccus 
may advance by leaps and bounds, if opportunity 
offers. This is the case at the time of the monthly 




Figure 1. Female pelvic organs in a healthy condition. 
— According to B. S. Schulze. 

B — -Womb, Bl — Bladder, md — Rectum, m and 1 — 
Ovaries, gg — Fallopian tubes, through which the female 
egg passes on its way to the womb; i and k — Ligaments, 
which hold the womb in place. 

period and, more especially, after confinement. 
The delivery of the child leaves the interior of the 
womb in a very vulnerable condition. It repre- 
sents one great sore and is easily invaded by the 
contagion. The microbes, formerly too weak to 
advance, now find it easy to ascend from the neck 



BY DR. FERDINAND HERB. 



43 



to the body of the womb, the Fallopian tubes, the 
ovaries and the abdominal cavity. Lodged there, 
they are beyond human reach, and conditions arise 




Figure 2. Female pelvic organs, distorted and grown 
together after an attack of gonorrheal inflammation. — 
According to Kuestner. 

a — Rectum, b — Womb, cc — Ovaries, dd — Fallopian 
tubes. 




Figure 3. Fallopian tubes converted into pus sacks 
after an attack of gonorrheal inflammation. — According to 
Hennig. 

a — Womb, bb — Fallopian tubes, slightly enlarged at 
end lying towards the womb, cc — Fallopian tubes, forming 
large pus sacks at end off from the womb, ee — Ovaries. 



44 GONORRHEA AND SEXUAL DEBILITY 

similar to those described in preceding pages. 

The blame naturally falls npon the attend- 
ants. Bnt a greater familiarity with the facts 
would in many instances relieve doctor and mid- 
wife of unjust impntations and pnt the blame 
where it belongs, namely, not to the nncleanliness 
and carelessness of those intrusted with the care 
of the parturient, bnt with the merciless contag- 
ion, which, lurking in its hidden place, grasped 
the opportunity of invasion. 

The following case, witnessed by the author, 
may serve as an illustration: 

A young woman of moderate means, who as 
a girl had had no ache or pain and menstruated 
normally, showed a slight derangement of her 
monthly period soon after marriage. A discharge 
ensued, exacerbating before and after the flow. 
Pregnancy came in dne time, and the child was 
delivered by a very careful midwife. In spite of 
all precautions fever developed. The physician 
summoned, found the young mother in a condition 
too serious to be treated at home and sent her to 
the hospital. Here, an examination revealed the 
following: Temperature 104° F.; lower abdomen 
extremely sensitive to the touch; womb larger 
than normal under the circumstances and very 
painful: ligaments swollen: right Fallopian tube 
converted into a pus sack the size of a woman's 
fist; ovaries imbedded in adhesions and also en- 
larged: defecation and urination extremely pain- 
ful. 

In spite of the most careful treatment, the 
condition of the patient improved but little, and, 
after six weeks of constant pain, day and night, 



BY DR. FERDINAND HERB. 45 

operation was resorted to. The pus tube and the 
right ovary were removed. Becovery was very 
slow and imperfect. 

The examination of the discharge from the 
womb, and of the pus from the tube, left no doubt 
as to the true cause of the trouble. Both present- 
ed the microbes of gonorrhea in great numbers. 
Further inquiries brought to light that the hus- 
band had suffered from gonorrhea three years be- 
fore marriage and, believing himself cured, never 
entertained doubt as to the safety of his wife. The 
revelation of the unmistakable fact came to him as 
a staggering blow; but the damage was done and 
remorse in vain. 



46 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER VI. 



DANGER TO THE OFFSPRING. 

Although a child, infected with gonorrhea, is 
subjected to the same manifold ailments and com- 
plications as the adult, his eyes, principally, are 
endangered by the gonococcus. It is a peculiarity 
of this microbe to find in mucous membrane of the 
eye just as favorable a breeding place as in the 
urethra and the female sexual organs. If the con- 
tagion happens to be inoculated while the head is 
passing through the parts of the diseased mother 
or afterwards, a serious inflammation of the eye 
results, which, in many instances, terminates in 
blindness. 

It is a pathetic and pitiful sight to see these 
fate-stricken children going through their lessons 
and doing their daily work in institutions devoted 
to their education. But more, infinitely more, 
pitiful is this sight if one considers that from 30 to 
60 per cent, of these blind wretches owe the loss of 
their precious sight to that same microbe that 
caused their father's "little dose" and their 
mother's woes and misery. We glean from statis- 
tics that of 30,000 blind people in Germany about 
10,000, and of 50,000 in the United States about 



BY DR. FERDINAND HERB. 47 

15,000, are doomed to the miseries of darkness and 
deprived of the priceless privilege of seeing the 
forms and faces of their loved ones, the objects 
about them, the brightness of the sunshine, 
through the infection with that terrible microbe: 
gonococeus. 

As heart-rending as these facts may be, they 
are far from expressing the real extent of the 
misery wrought by this horrible and odious 
malady. Not every child taken ill becomes blind. 
In most instances, in which evil consequences 
remain, the vision of but one eye is diminished or 
lost. The multitude of those unfortunates who 
are more or less restricted in their capacity of 
earning a livelihood and who are hampered in 
their competition with their fellow-men, dragging 
out a miserable existence because of their "weak 
eyes," are not included in this enumeration. If it 
were possible to ascertain their number, we think 
that 100,000 would not reach the mark in the 
United States alone. 

May these truths contribute their mite in con- 
vincing the public that the "little dose" is not a 
simple affair, but one of the most serious scourges 
that plague humanity. 



48 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER Vn. 



STERILITY IN MARRIAGE. 



According to Kisch (Die Sterilitaet des 
TTeibes, page 271) 10 per cent, of all marriages 
are sterile. Computing five members to the aver- 
age family, we have in the United States, with its 
80 million inhabitants, about 16 million families. 
Of these, 1.6 millions are sterile. The percentage 
of sterility, caused by the ravages of gonorrhea, is 
about half of the total; that is to say, about 800,000 
families are childless in the United States because 
the gonococcus made them so. These figures 
alone, without taking in consideration the infinite 
pain, suffering, misery, mutilation and death re- 
ferable to the same source, are appalling. They 
merit consideration as another proof for our re- 
peated assertion that the "little dose" is one of 
the most destructive diseases the human race is 
heir to. 

In former years, sterility in marriage was 
always attributed to the female. Today, we 
know that in one of every three cases the male is 
to blame. 

As to sterility in men, we refer to a later 
chapter. 



BY DR. FERDINAND HERB. 49 

Sterility in women is brought about by the 
morbid! changes caused by the gonococcus in the 
lining of the womb, the Fallopian tubes and the 
ovaries. Fertilization and implantation of the 
female egg become impossible and remain so in 
spite of all medical treatment, or even operations, 
to. which so many women gladly submit in their 
consuming desire for children. The barriers, 
created by gonorrhea, prove insurmountable. 
Deprived of the hope of offspring, the very object 
for which marriage was entered into, many an 
unfortunate sufferer leads a life of dissatisfaction 
and despondency, ignorant of the fact— and, per- 
haps, best so — that it was not an unavoidable fate, 
but the interference of that tiny microbe that 
shrouded her life in gloom and darkness. 



50 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER Vin. 



CONTAGION OF GONORRHEA. 

Gonorrhea is caused by the transmission or 
inoculation of a specific microbe, called "GONO- 
COCCTJS." It was discovered by Professor 
Neisser of Breslau, Germany, in the year of 1879, 
and proved conclusively to be the cause, and the 
only cause, of the disease in question. 




Figure 4. Gonococci. 1 — Gonococci lying free in the 
secretion, 2 — Gonococci lying in pus cells, 3 — Gonococci 
ly-'ng in epithilial cells. 



BY DR. FERDINAND HERB. 51 

Figure 4 shows the microbes, or disease 
germs, as they look under the microscope. They 
always lie in pairs. This makes them resemble 
the form of a coffee-bean. They are partially free 
in the secretions, partially imbedded in pus cells. 



52 > GONORRHEA AND SEXUAL DEBILITY 



CHAPTEB IX. 



MODE OF INFECTION. 



By the name "Gonorrhea" or "Clap" is 
understood a specific inflammation of the urinary 
or sexual organs, caused by a specific microbe, the 
gonococcus. Infection with gonorrhea is, there- 
fore, possible only by the transmission of, and 
inoculation with, this very gonococcus. 

This fact should be borne in mind. It should 
force us to abandon the old view that gonorrhea 
can be contracted by urinating against the wind, 
too great exertion during coition, withdrawal, 
catching cold, etc., etc. Where there is no 
gonococcus, there is no gonorrhea, and vice versa. 
If, accordingly, a person contracts gonorrhea, that 
is, contracts a discharge which contains gonococci, 
he or she is absolutely right in the assumption that 
his or her partner is diseased, no matter to what 
class of society either may belong. Utterances like 
"It is impossible, the person is clean, honest and 
respectable," etc., are frequently heard, but are 
usually met with a smile by the physician. And 
this is done not because he doubts or wishes to dis- 
credit any one's character, but because he knows 
that gonorrhea is a very common disease and often 
lurks where least expected. 

Attention may here be called to a peculiar 
phenomenon, which might puzzle the uninitiated. 

It is a strange, though not infrequent, occur- 



BY DR. FERDINAND HERB. 53 

rence that a man is suddenly startled by the un- 
mistakable fact that he has contracted gonorrhea 
after indulging in sexual relations with the same 
woman for weeks, or months, or years. How is 
this possible? If gonorrhea comes but from 
gonorrhea, does it follow that the woman has 
gonorrhea? We say "Most certainly." Then, 
the question arises: "Why did not the infection 
come sooner?" The explanation is this: The 
microbes are weak in many cases of gonorrheal 
infection in women. They are unable to be 
aggressive and hide in the folds of the neck of the 
womb without causing much disturbance, except 
a slight occasional discharge. This latter, under 
ordinary circumstances, very often contains no 
specific microbes and, hence, infection cannot 
occur. But let conditions arise which, with an 
increase of discharge, lead to a loosening and 
shedding of those cells in which the enemy lurks, 
as, for instance, in cases of cold, incipient illness 
of any nature, lowered vitality, monthly period 
and, especially, confinement,— and the gonococcus 
will at once re-appear in the secretions. Yes, 
these latter may at such times be swarming with 
the specific germs, while they ordinarily show no 
trace of them. Then, of course, infection is 
probable. 

Should, therefore, a man unexpectedly con- 
tract gonorrhea from his wife, it does not neces- 
sarily follow that she has been untrue to him. By 
no means! The possibility exists that she con- 
tracted the chronic infection long before this mar- 
riage or, perhaps, was infected by him who later 
received back, in a condition of intensified viru- 



54 GONORRHEA AND SEXUAL DEBILITY 

lence, the contagion with which he himself origin- 
ally sullied her. May this explanation be an inci- 
tation to married men, should they meet with such 
an incident, to be just and not to accuse their 
wives of infidelity before they have looked over 
their own record and are sure of their own spot- 
lessness. 

One or two more questions of perplexing na- 
ture may be raised in this connection, namely: 
' ' Why does it sometimes happen that of two men, 
visiting the same woman, one contracts gonorrhea, 
the other escapes?" or ''Why does one man con- 
tract gonorrhea easily and another not at all?" 
Does there exist such a thing as ^Immunity from 
Gonorrhea?" All these questions are answered 
by stating that it all depends on the fact whether 
or not the gonococcus finds opportunity to lodge in 
the urethra. The cleaner the woman, the less is 
the chance of infection. The longer and the more 
protracted the embrace, as for instance under the 
influence of alcohol, the greater is the chance of 
infection, other things being equal. The position 
of the mouth of the male urethra is also of great 
influence. The lower the outlet, the easier does 
the discharge of the vagina find its way into it, 
and the more likely is the infection. 

If the gonococcus lodges in the urethra, the 
disease is established, no matter who it is. A so- 
called "Immunity" does not exist. If one has 
often been exposed to, but never contracted, 
gonorrhea, all he can claim is that he had good 
luck. Xo one should rely on the false supposition 
that he cannot contract gonorrhea, lest some day 
he may be bitterly disillusioned. 



BY DR. FERDINAND HERB. 55 



CHAPTER X. 



NOT EVERY DISCHARGE A GONORRHEA. 

As repeatedly stated, gonorrhea is a specific 
disease, caused by a specific microbe, the gonococ- 
cus. Upon the presence of this very gonococcus 
the greatest importance should be laid. For dis- 
charges from the urethra occur which contain no 
gonococci and present, consequently, no gonorrhea 
but simply a catarrh of the urethra. 

The beginning of a non-specific discharge of 
this latter kind may, or may not, be preceded by 
sexual intercourse. In the first instance, it is 
usually caused by an irritating secretion from the 
womb on account of catarrh, poverty of blood, 
etc, ; in the second instance, it is caused by a stone 
or other foreign body in the urethra, a sharp and 
irritating urine, the friction of an improper saddle, 
while bicycling, or many other reasons. 

The frequency of these non-specific discharges 
is 20 per cent. ; that is, of every five cases looking 
like gonorrhea, one is no gonorrhea but a simple 
catarrh of the urethra. This latter is usually of 
but short duration and vanishes after a few days 
without local treatment. Barely is it more obsti- 
nate. It may, however, sometimes exhibit the 



56 GONORRHEA ^ND SEXUAL DEBILITY 

same stubbornness as a true gonorrhea, especially 
if the cause of the irritation has not been recog- 
nized and removed. 

These facts should be carefully borne in mind. 
The distinction between these two diseases cannot 
be drawn except with the microscope. This in- 
strument is, therefore, indispensable to a proper 
decision and should always be employed if the 
slightest doubt exists as to the character of the 
discharge. 



BY DR. FERDINAND HERB. 57 



CHAPTER XI. 



HOW AND WHERE GONORRHEA IS CONTRACTED. 

Men practically always contract gonorrhea 
during sexual intercourse. Some strange coinci- 
dence may sometimes cause the gonococcus to 
find its way into the male urethra in some other 
manner, as, for instance, from soiled fingers, 
cloths, in the bath, on the closet, etc, ; but these in- 
stances are very rare indeed. We have mentioned 
them because these modes of infection are very 
frequently claimed by those who try to shirk the 
responsibility of their wrongdoings. Such state- 
ments are, however, received with proper reserve 
by the expert, who knows very well that people, 
otherwise absolutely dependable, do not balk at a 
falsehood in order to maintain a pretense of 
virtue. 

It is a different matter with women and chil- 
dren. They are often infected in an innocent way 
by using sponges, cloths, syringes, etc. in common 
with diseased sisters, mothers, neighbors and 
friends. 



58 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XII. 



HOW TO PREVENT GONORRHEA. 

In the case of exposure, infection with gonor- 
rhea is prevented by removing or killing the 
specific germs before they have a chance to settle. 

This may be accomplished: First, by me- 
chanically cleaning the penis with soap and water 
and emptying the bladder. The normally flowing 
urine carries out the grosser particles of slime 
which may have entered the urethra. The finer 
particles, however, cannot be removed in this man- 
ner, as they lodge between the folds of the mucous 
membrane and in the outlets of the numerous 
glands emptying at random all along the entire 
length of the canal. 

In order to understand these suggestions, it is 
necessary to dwell briefly upon the anatomy and 
physiology of these organs. When the penis 
erects, the entire circumference grows bigger and 
the urethra unfolds, so to speak, that is, forms an 
open tube with the mucous membrane stretched 
and the mouths of the glands yawning. As soon 
as erection subsides, the normal form returns, the 
circumference diminishes, the mucous membrane 
shrinks and folds up, and the mouths of the glands 



BY DR. FERDINAND HERB. 59 

collapse. Whatever slime has been lodged be- 
tween these folds and in the open mouths of the 
glands cannot, therefore, be swept away by the 
urine when the penis is in a flaccid condition. To 
remove these, the urethra must again be unfolded 
to its fullest possible extent and the strength of 
the urinary current increased. Both conditions 
are fulfilled by closing the outlet of the canal with 
the finger periodically while the water is flowing. 
Thus the most is made of the urine as a mechanical 
cleanser, as it unfolds the urethra effectively and 
leaves in forceful gushes. 




O 



Figure 5. The larger circle represents the penis 
erected and the urethra unfolded; the smaller circle repre- 
sents the penis in a flaccid condition and the urethral mem- 
brane folded up. 

From the foregoing it becomes evident that 
urination as a prophylactic is more effective, the 
more urine stands at disposal (hold urine before 
the act), the quicker it is discharged after 
cohabitation, the stronger the stream is and the 
thinner and less sticky the infectious material. 

Second: Although urination is a splendid 
preventive, it should not be depended upon alone. 
Chemicals should further be used to kill those 
germs which may have remained. This is accom- 



60 GONORRHEA AND SEXUAL DEBILITY 

plished by instilling a drop or two of one of the 
following solutions into the urethra directly after 
urination. 

Prescription 1. 

Rheno Silver Compound 1 vial 

Dissolve in one ounce of freshly boiled 
water. 

Prescription 2. 

Protargol % drachm 

Distilled Water 1 ounce 

Pour powder upon water in bottle and 
allow to stand until dissolved. 

Prescription 3. 

Solution of Hydrogen Dioxide 1 ounce 

The first two remedies are preferable, but the 
last is most readily obtained. 

This installation is usually sufficient. Under 
ordinary circumstances, the infectious material 
remains at the little spacious dilatation which lies 
directly at the outlet of the urinary canal and is 
thus easilv reached. 




Figure 6. a — Spacious dilatation at the outlet of the 

urethra. 

If, however, the mouth of the urethra is very 
wide and offers an easy access, or the discharge of 
the woman very profuse, or cohabitation pro- 
tracted,— the chances are that the microbes have 
already arrived at a place beyond the reach of 



BY DR. FERDINAND HERB. 



61 



medicines dropped upon the outlet. In such in- 
stances, the entire front half of the canal should 
be irrigated in the following way: Wash; urinate 
as stated; compress urethra between thumb and 
second finger at the junction of the penis with the 
pouch of the testicles (Figure 7) ; inject one of the 
following solutions, using so much pressure that a 
slight pain arises from the dilatation of the canal; 
hold the remedy in for five to ten minutes and 
allow it to escape. 




Figure 7. aa — Place where to compress the urethra. 

dosing the urethra at the junction of the 
penis with the pouch of the testicles keeps the 
solution from flowing into the deeper parts of the 
urethra, where it is not required; the pressure, 
exerted with the syringe, unfolds the mucous 



62 GONORRHEA AND SEXUAL DEBILITY 

membrane and! allows the solution to reach every 
nook where the germ might have found a hiding 
place. 

The solutions are: 

Prescription 4. 

Rheno Silver Compound 1 vial 

Water 2 ounces 

Prescription 5. 

Protargol % drachm 

Distilled Water 3 ounces 

These two procedures afford a fairly good 
protection against infection with gonorrhea, pro- 
vided they are employed immediately after 
cohabitation and faithfully carried out. 



BY DR. FERDINAND HERB. 63 



CHAPTER XHI. 



ACUTE GONORRHEA. 



Time of Incubation:- The time of incubation, 
that is, the time between the moment of infection 
and the development of the first symptoms, varies 
all the way from two to ten days. Three to six 
days is the average. The disease rarely develops 
after the tenth day. Cases, where patients do not 
notice the discharge until weeks or even months 
after the last exposure, are explainable only on the 
supposition that the discharge started at the 
proper time but escaped attention until noticed 
accidentally. This may happen if it is so slight 
that it causes no inconvenience whatever and an 
exacerbation is required to bring it to knowledge. 

Symptoms:— The first symptom of gonorrhea 
is a tickling or itching sensation at the end of the 
urethra. Upon inspection the outlet is found to 
be reddened and slightly swollen, and a little slimy 
discharge exudes on pressure. 

This ' ' mucous stage ' ■ does not last long. The 
itching sensation soon turns into an uncomfort- 
able, dull pain, which becomes of stinging charac- 
ter during urination. The redness and swelling 
increase, the discharge becomes more abundant 



64 GONORRHEA AND SEXUAL DEBILITY 

and changes from a slimy to a purulent character. 
On or about the fifth day, the disease is at its 
height. Urination grows more difficult and the 
stream smaller, forked ■ or dribbling. Complete 
retention of urine is rare and usually follows in 
the wake of dissipation, cohabitation or other 
excesses. 

The urethral canal can often be felt all along 
the lower side of the penis as a hard, solid cord, 
sensitive to the touch. Eed, painful streaks run 
along the back of the penis from the head towards 
the root. They represent the road on which the 
poison travels from the seat of the infection to the 
body. The glands in the groins participate in the 
inflammation according to the extent of this ab- 
sorption of poison. Their reaction is commensu- 
rate and varies from a dull aching with slight en- 
largement to the formation of large swellings and 
subsequent abscesses. 

The foreskin also becomes inflamed in all 
severe cases and reacts with a dropsical swelling. 
If this be large, its retraction behind the head be- 
comes impossible; the pus accumulates under it 
and by increasing the inflammation increases the 
swelling. Thus it happens that in some cases the 
penis looks strangely deformed and resembles in 
appearance the clapper of a bell. 

Fever is frequently present, but only in the 
beginning. It is not high and subsides in a few 
days or a week. 

Happily, the trying symptoms do not remain 
long at the height referred to. Quickly with, 
more slowly without, treatment the pains decrease 
and vanish, the swelling subsides, urination be- 



BY DR. FERDINAND HERB. 65 

comes easier and the discharge thinner and less in 
quantity, nntil finally the former feeling of health 
returns. An occasional drop during the day, or 
upon rising, is the last reminder, not only of the 
little drama just experienced, but also of the fact 
that the disease is not yet cured. 

It would be a great mistake to assume that all 
cases are alike. They vary as much as the in- 
dividuals afflicted. While a good many run the 
severe course above described, many are lighter 
and some so light that they may escape attention. 

Variations of the Discharge. — The discharge 
is ordinarily abundant in quantity and of greenish 
yellow hue, but may vary in color and be of all 
shades from milk-white to dark-brown or black. 
The dark color is caused by the admixture of 
blood. In rare cases, in which the inflammation 
is very pronounced and extends deep into the tis- 
sue, clear, bright blood may appear. 

Instead of the thick, greenish-yellow pus, 
there may, however, be a thin, milky fluid, or even 
one of slimy nature. A discharge, slimy from the 
start, is rarely found in the first, more often in a 
later attack, a phenomenon which corresponds 
with the fact that subsequent infections usually 
run a milder course. 

The same variation is true as to the quantity 
of pus. While in most instances it is so abundant 
as to run from the urethra of its own accord, in 
others it requires pressure to force it out. More 
rarely, especially in later infections, it is neces- 
sary to milk from far back before secretion ap- 
pears at the outlet of the canal. It is in these 
instances that the infection may be entirely over- 



66 GONORRHEA AND SEXUAL DEBILITY 



looked and the diseased person taken by surprise 
when an aggravation, or arising complication, 
reveals its presence. In these cases it is often 
rather difficult to decide whether we have to deal 
with a new infection or an exacerbation of the old 
disease. The first is usually assumed, but the 
latter mostly true. Many of those who are seem- 
ingly "blessed" with a new attack after every dis- 
sipation would find their lot less unfortunate if 
they were to take the trouble to once thoroughly 
cure their "old affair." 

Variations of the Pain. — The pain, of course, 
also varies greatly. It is sometimes continual, 
mostly, however, prominent only during urination, 
when it feels as if boiling water or a red hot iron 
were passing through the penis. 

The pain is most severe during erections. 
Then, they seem almost unbearable and are, in- 
deed, a torture. Coming, as they do, most fre- 
quently during the night, and especially towards 
morning, they often render sleep impossible. No 
wonder, therefore, that the painful erections, 
called ' ' Chordee, ' ' are one of those trying compli- 
cations of the "little dose" which, during sleep- 
less hours, are apt to impress upon the mind of the 
patient the seriousness of gonorrhea and, through 
pain and wakeful nights, may break down a robust 
constitution within a remarkably short time. 

However, while some suffer as above de- 
scribed, others may not be aware of the infection 
because of the slightness of the symptoms. 
We have often heard the opinion expressed that 
the existing discharge could not be gonorrhea as 
there was no pain. But this is an error. Great or 



BY DR. FERDINAND HERB. 67 

little pain, great or little discharge, the disease is 
gonorrhea if there is pus and the gonococcus is 
in it. 

Treatment. — Best. — Quietness of the body 
is essential so long as the disease is at its 
height. Repose in bed is best, but as a rule not 
obtainable. Fear of exposure, social duties, the 
necessity of earning a living, etc., restrain most 
patients from lying down. Rest in bed may, 
therefore, be reserved for very severe cases and 
those with grave complications:; but violent exer- 
cises, such as running, foot or base ball playing, 
dancing, lifting heavy loads, climbing high stairs 
or mountains, jumping from street cars, trains, 
etc., and especially bicycling and horse back rid- 
ing, should always be avoided. Long standing 
and the continual jarring of long drives and ex- 
tensive railroad trips are also harmful. 

It goes without saying that every and all sex- 
ual excitement, and especially cohabitation, are 
strictly forbidden. For a gonorrheic to fondle 
women and to rouse his passions means to prolong 
the disease. 

Diet. — The diet must be plain and consist of 
bread and butter, vegetables of all sorts, fish, 
meats in moderation, breakfast foods, rice, oat- 
meal, etc. Game and heavy dishes are objec- 
tionable. 

Supper should be taken early, at least three 
hours before going to bed. 

Forbidden are: Asparagus, celery, pickles, 
salted herring, radishes, mustard, onions, vinegar, 
and all spices and spiced and strongly salted 
dishes. 



68 GONORRHEA AND SEXUAL DEBILITY 

Forbidden are further: Beer, wine, whisky, 
brandy, gin, liquors, porter, ale, champagne, and 
all other alcoholic beverages. 

Coffee and tea are permitted with a large ad- 
mixture of milk. Smoking and chewing have 
ordinarily no effect on gonorrhea, if used in mod- 
eration, and are, therefore, not prohibited. 

Recommended are an abundance of fresh 
water and milk and butter-milk. They dilute the 
urine and render it less acid and irritating. A 
frequent flow of water keeps the urethra clean and 
tends to prevent the infection of the bladder. 

Local Cleanliness. — Local cleanliness is of 
great importance. The penis should be washed 
several times a day with soap and warm water 
after the foreskin has been retracted. This done, 
a piece of absorbent cotton is tucked into the 
spa^ce between the foreskin and the head of the 
penis, so that a thick layer covers the mouth of the 
urethra. Thus the cotton absorbes the exuding 
discharge and keeps it from soiling the skin and 
clothes. It should be renewed as often as wet, if 
necessary every half hour to an hour. In later 
stages, a renewal two or three times a day will be 
sufficient. If there is no foreskin, a small band- 
age containing absorbent cotton is advisable. 

Cleanliness of Hands and Surroimdings. — 
Each time after touching the genitals, a thorough 
cleaning of the hands with soap and water cannot 
be too urgently recommended, in view of the enor- 
mous danger which threatens the eyes should the 
smallest particle of gonorrheal matter come in 
contact with them. 

In Chapter 6 we have learned that the mucous 



BY DRJERDINAND HERB. 69 

membrane of this organ is a favorite breeding 
place for the gonococcus, and that its inoculation 
into the eye of the newborn yearly causes thou- 
sands of cases of blindness. What this specific 
germ does to the eye of the baby, it does to the eye 
of the adult, that is, it may destroy its sight. 
Therefore, caution, great caution, the very great- 
est caution should be the ever present admonition. 

The mischief that may be wrought through 
carelessness with gonorrheal matter is forcibly 
demonstrated by the following cases of our ex- 
perience. 

First case. A boy, aged 12, was led by his 
mother into the consulting room of the Eye Hospi- 
tal in Munich, both eyes bundled up. They start- 
ed to become sore some days previous and were 
now presented for treatment, as home remedies 
seemed to fail. The removal of the bandage dis- 
closed a most pitiful sight. Eyelids swollen, 
bathed in pus; mucous membrane within highly 
inflamed and covered with blood and matter; 
corneae ulcerating. It was evident at once that 
the sight was practically lost, and thus it proved 
to be. Just enough of it was saved for the poor 
wretch to enable him to dimly see the objects 
around him and with difficulty to find his way on 
the streets. 

Numerous gonococci were present in the pus. 
The boy had no gonorrhea himself, but further in- 
quiry disclosed the fact that he slept with an older 
brother of 20; that this brother had an attack of 
acute gonorrhea; and that the unfortunate little 
fellow infected his eyes with the poisonous matter 
through the medium of the soiled bed clothes. 



70 GONORRHEA AND SEXUAL DEBILITY 

Second case. An old, feeble man arrived at 
the Eye Hospital in Vienna with eyes reddened, 
swollen and filled with purulent discharge, con- 
taining numerous gonococci. The corneae were 
not yet injured and the sight was saved. 

The usual inquiry into ''the reason why" 
brought to light that the son suffered from gonor- 
rhea, and that he, the father, infected his eyes in 
the bath tub which he used shortly after his son. 

Further comment does not seem necessary, as 
the lesson to be drawn is too obvious. 

Regularity of Bowels. — The bowels are apt to 
be constipated in the beginning of gonorrhea. It 
is well, therefore, to have their regularity main- 
tained, if necessary, by an occasional laxative, the 
selection of which is left to the individual taste. 

Application of a Suspensory. — The applica- 
tion of a suspensory is indispensable in every case 
of gonorrhea, whether severe or light, whether 
acute or chronic. It is mentioned here only for 
the purpose of attracting the attention to this im- 
portant accessory. Particulars will be found in 
the chapter on ' ' Inflammation of the Testicles. ' ' 

Application of Heat. — Before we enter upon 
the specific treatment, let us consider a therapeu- 
tic agent which is of the greatest benefit in the 
warfare upon gonorrhea, namely: Heat. The 
practical application of this great natural remedy 
is based upon the fact that the gonococci are very 
sensitive to it. Even those temperatures encoun- 
tered during ordinary high fever, say 104 to 105 
degrees F., impair their vitality or kill them off. 
The removal of the cause, of course, hastens the 
cure very materially, or better, practically insures 



BY DR. FERDINAND HERB. 71 

it. In support of this fact, Dr. Abutkow (Wratch 
1898 No. 8) cites the history of a number of cases, 
which during the course of febrile diseases were 
incidentally also relieved of their long standing 
gleet, theretofore obstinately resisting the routine 
treatment. The gonococci disappeared first, and 
the discharge ceased a few days later. Supported 
by similar experiences, Drs. H. Quinke and Solo- 
mon (Berliner Klinische Wochenschrift, Decem- 
ber 6th, 1897,) highly recommend the treatment of 
gonorrhea with hot poultices, concluding their 
essay by saying that, although the local rise of 
temperature effected thereby does not bring a per- 
fect cure in every case, it is a great help and goes 
far to support the regular treatment. 

But in order to be effective, the heat must be 
as intense as possibly can be borne. The higher 
the degree and the longer the application, the bet- 
ter the effect. 

There are numerous ways in which heat may 
be applied in the treatment of gonorrhea. 

First, by means of poultices or other hot ob- 
jects of different description, such as hot sand 
bags, hot salt sacks, hot water bags, etc. Poul- 
tices are best made of linseed meal. They are pre- 
pared by mixing it with boiling water. The re- 
sulting dough is applied wrapped in cloths. 

Second, by means of hot water baths. They 
are made by bathing the parts in water as hot as 
bearable. 

Third, by means of hot hip baths. They are 
very beneficial in affections of the penis, the pros- 
tate gland and the bladder. The only utensil 
necessary is a small bath or wash tub or any other 



72 GONORRHEA *JMD SEXUAL DEBILITY 

receptacle sufficiently large to sit in. 

How to proceed: Warm up room; fill tub 
with hot water four to five inches deep; sit down 
into it in such a way that legs are outside of tub; 
have attendant slowly add more water of higher 
temperature until hips are well submerged and 
heat is as great as can be borne; stay in for fifteen 
to thirty minutes; rise and go to bed, which must 
be well warmed before hand, so that the body will 
not be chilled. Repeat bath as may seem benefi- 
cial. 

Fourth, by means of hot injections into the 
urethra with a common glass syringe. They are 
made as follows: Wash penis with soap and 
warm water; urinate; fill syringe with water as 
hot as can comfortably be borne ;inject slowly into 
the urethra and hold there for five to ten minutes. 
A second injection, immediately following the 
first, is often of decided benefit. Of this method 
Dr. Stern (Deutsche Medicinische Wochenschrift 
1907, page 222) says: "I have seen very good 
results from this procedure. At any rate, it sur- 
prised me, especially in my private practice, that 
cases, unresponsive for many months to the ordi- 
nary injection therapy, were cured quickly and 
permanently when I ordered these hot water ap- 
plications to precede the regular injections. ' ' He 
employed a temperature of about 100 degrees F., 
but adds: "The temperature of the water can be 
raised to the highest point of endurance without 
damage to the urethra and apparently with good 
success. ' ' 

Fifth, by means of irrigations of the urethra 
with hot water. Instruments necessary: Foun- 



BY DR. FERDINAND HERB. 



73 



tain syringe (Figure 8) and soft rubber catheter 
(Figure 9). The size of the latter must be chosen 
according to circumstances. The urethra, and 
especially its mouth, are different in caliber with 
different persons. The largest size of catheter 
should be selected that easily passes up to the 
bladder and leaves sufficient space around itself 
for the water to return. 




Figure 8. Fountain Syringe. 
to be connected with irrigator. 



F — Smallest end piece 




Figure 9. Soft Rubber Catheter for irrigation. 

How to proceed: Boil two or three quarts of 
fresh, clean water and allow to cool until tempera- 
ture has fallen to from 140 to 130 degrees F. ; fill 
into clean fountain syringe and hang this up four 
to six feet from floor; connect soft catheter with 
tube of syringe by means of smallest end piece 



74 GONORRHEA AND SEXUAL DEBILITY 

(Figure 8) and place it upon a chair within easy 
reach on a freshly washed towel. Then wash 
penis with soap and warm water; pass urine in 
order to remove all discharge from the urethra; 
strip trousers to below the knees and sit down 
upon a chair in such a manner that the seat rests 
upon the edge and the shoulders lean against the 
back (Figure 10). Now take catheter; dip end two 
or three inches deep into glycerine or fluid paraf- 

t 




Figure 10. Position how to sit on the chair while 
irrigating; a — Seat at the edge of the chair; b — Shoulders 
leaning against the back of the chair. 

fine; allow water to escape until it comes out hot, 
and, while this 1 is running, insert catheter up into 
the urethra as far as to the neck of the bladder^ 
keep it there until syringe is empty, when the 
catheter can be withdrawn and the treatment 
is finished. 



BY DR. FERDINAND HERB. 75 

The temperature of the water should be as 
high as can comfortably be borne. The hotter 
the fluid, the better the result. The limits of 
choice lie between 120 to 140 degrees F. 

Scrupulous cleanliness of all instruments is 
of vital importance. An infection of the urethra 
or the bladder with microbes, introduced with the 
utensils, is dangerous. It must and can be avoid- 
ed. To this end, the hands should be thoroughly 
cleaned first with soap and warm water and, then, 
with a solution of Ehenolin (Prescription 6) ; the 
water, used, be freshly boiled ; the syringe, tubing 
and end-piece be cooked every day or every other 
day ; and the contact of the catheter with unclean 
objects be avoided. After the treatment, all 
instruments should be wrapped in a clean towel 
and thus laid aside. 

Prescription 6. 

Rhenolin 4 ounces 

One to two teaspoonfuls to a quart of hot 
water. 

One question needs further ventilation, 
namely, "When does the point of the catheter 
reach the neck of the bladder?" This can easily 
be recognized. The point is in the urethra so long 
as the water comes out aside of the instrument; 
as soon as it enters the bladder, the return flow 
stops. If this happens, withdraw the catheter so 
far that the water again flows out and hold it at 
this point until finished. 

Another way to proceed is this: Introduce 
catheter when not connected with syringe until 
urine comes; then, withdraw it a little, until the 
flow of urine stops; mark this point and always 



76 GONORRHEA AND SEXUAL DEBILITY 

thereafter insert instrument up to this mark while 
irrigating. 

Sixth, by means of injections of hot water 
into the rectum. These are of great benefit in all 
cases of inflammatory affections of the deeper 
parts of the urethra, the prostate gland and the 
seminal vesicles. 

Instruments necessary: Fountain syringe 
(Figure 8) and special rectal tube for irrigating 
(Figure 11). This latter allows inflow and outflow 
of the water simultaneously. 




Figure 11. Rectal irrigator. The arrows show the 
direction in which the water flows in and out. 

How to proceed: Boil two or three quarts of 
water and cool to from 130 to 115 degrees F.; 
connect syringe with rectal tube; sit on edge of 
chair, the seat projecting, or, better, on cane chair, 
the cane cut out in the center; place vessel under 
you to receive water; lubricate rectal tube with 
vaseline, insert it and start water, regulating the 
flow, so that inflow and outflow keep about the 
same. When the bag is empty, withdraw tube 
and rest. 

It is sometimes a little difficult to regulate the 
flow properly at first, but the necessary skill is 
soon acquired by experience. 

If the rectum is too sensitive and a rather 
ugly sensation follows the treatment, rectal irri- 
gations had better not be attempted. Such cases, 
however, are rare. 



BY DR. FERDINAND HERB. 77 



CHAPTER XIV. 



CONDITION OF URINE. 

* ' 

The condition of the nrine has a decided in- 
fluence npon the gonorrheal inflammation in so far 
as a urine, thick and of acid character, unduly 
irritates the tender membrane and delays healing. 

Should, therefore, the urine be very "hot," 
smart considerably, be dark and scanty, it be- 
comes necessary to increase its volume and coun- 
teract acidity by drinking more fluid, and taking 
one of the following remedies. 

Prescription 7. 

Sodium Bicarbonate 2 ounces 

One-third to one-half teaspoonful in water 
between meals. 

This remedy is generally used and renders 
the urine quickly alkaline. It should be taken 
between or one or two hours before meals. 

The same does a Solution of Potassium 
Hydroxide (Prescription 8), which is also fre- 
quently employed. 

Prescription 8. 

Solution of Potassium Hydroxide ... 2 ounces 
Ten to twenty drops, freely diluted in 
water, four to six times a day. 



78 GONORRHEA AND SEXUAL DEBILITY 

Where it is desirable to render the urine 
alkaline and, at the same time, to stimulate its 
flow, the remedy in Prescription 9 is preferable. 

Prescription 9. 

Potassium Citrate 1 ounce 

Syrup of Cinnamon, enough, to make. .4 ozs. 
One teaspoonful in half a glassful of water 
every two to four hours. 

An addition of Sweet Spirits of Nitre to the 
above remedy (Prescription 10) is appropriate to 
allay a co-existing irritation of the bladder and 
Mdneys. 

Prescription 10. 

Potassium Citrate 1 ounce 

Spirit of Nitrous Ether 1 *£ ounces 

Syrup of Cinnamon, enough to make. .4 ozs. 
One teaspoonful in half a glassful of water 
every two to four hours. 

Balsamic remedies are also often used for the 
same purpose. As to these, we refer to the chap- 
ter on "Internal Remedies." 



BY DR. FERDINAND HERB. 79 



CHAPTER XV. 



URINARY ANTISEPTICS. 



It is evident that a urine antiseptic of itself 
will not only assist in healing the urethral affec- 
tion, but also help materially in preventing infec- 
tion of the bladder and the kidneys. "We, there- 
fore, urgently recommend one of the following 
remedies in all cases of gonorrhea, acute or 
chronic, partly as a preventive, partly as a support 
of the regular local treatment. 

The best is Methylene Blue in the following 
combination (Prescription 11) : 

Prescription 11. 

Methylene Blue, 

Nutmeg, each 2 grains 

Make into tablet, pill or capsule. One 

three times a day after meals. 

It renders the urine greenish-blue and may, 
sometimes, cause a slight burning in urination. 
To drink a little more water or decrease the dose 
from three to two tablets a day, one in the morn- 
ing and one in the evening, will obviate the diffi- 
culty. 

We advise against the use of Methylene Blue 
in combination with Oil of Santal, Copaiba, or Oil 



80 GONORRHEA AND SEXUAL DEBILITY 

of Cubeb. These latter remedies are not always 
harmless and should not be taken except where in- 
dicated ( see chapter on "Internal B^medies")- 
Another remedy is Hexamethylenamine 
(Prescription 12) . 

Prescription 12. 

Hexamethylenamine .. 4 grain tablets, No. 50 
One tablet three times a day. 

, It has the advantage of non-coloring the 
water, bnt does sometimes irritate the kidneys. 
We have seen a number of cases where the nrine 
assumed a bloody appearance npon taking this 
drug, and have, in most instances, discarded it in 
favor of Methylene Bine. 

A great number of other urinary antiseptics 
are occasionally prescribed by physicians, but 
they are less effective and do not warrant further 
mention. 






BY DR. FERDINAND HERB. 81 



CHAPTEE XVI. 



TREATMENT OF CHORDEE. 

Chordee, that is, painful erections, is so 
annoying in many instances that it is worthy of 
special mention. 

The penis is in a somewhat tumescent con- 
dition all the time in severe cases of gonorrhea, 
but not so as to be painful. If, however, full 
erections occur, suffering becomes acute. 

Chordee can be prevented: 

First, by restricting the amount of fluid be- 
fore retiring, as a full bladder favors erections. 

Second, by hot water baths (see Chapter 13). 

Third, by hot hip baths (see Chapter 13). 
They should be of Hive to ten minutes duration. 

If erection occurs, the patient should urinate 
and then apply ice water or any cold object to the 
penis. It must not be forcibly bent down as this 
may cause strictures. 

Of remedies, Bromides are prescribed most 
frequently and are often of decided benefit (Pre- 
scription 13). 

Prescription 13. 

Potassium Bromide, 

Sodium Bromide, each 1 ounce 

Ammonium Bromide V 2 ounce 

Syrup of Orange, enough to make . . 4 ounces 
One to one and one-half teaspoonfuls at 
bed time. 



82 GONORRHEA AND SEXUAL DEBILITY 

We have had good success in a number of 
instances with Antipyrine, in doses of from nine 
to eighteen grains before retiring (Prescription 
14). 

Prescription 14. 

Antipyrine % ounce 

Syrup of Orange, enough to make . . 4 ounces 
One to two teaspoonfuls at bed time. 

In some cases, Oil of Santal, Copaiba, or Oil 
of Cubeb do better and can be tried if Bromides 
and Antipyrine should fail (see chapter on "In- 
ternal Eemedies ,, ). 

In severe cases nothing short of Morphine or 
Codeine will fill the bill. 



BY DR. FERDINAND HERB. 83 



CHAPTER XVn. 



SUDDEN STOPPAGE OF URINE. 

The sudden stoppage of urine is a most dis- 
tressing incident. It is caused by a swelling in 
the urethra, and usually follows in the wake of 
dissipation or maltreatment. To relieve it, a hot 
hip bath should be prepared at once as described 
in Chapter 13. This starts the flow most speedily. 
Should it give no satisfaction, a catheter must be 
introduced and the water drawn. The perform- 
ance of this operation is ordinarily easy. Care, 
however, should be taken to do it antiseptically 
and under full observation of all the precautions 
given in Chapter 13. 

Methylene Blue, in combination with balsamic 
remedies (see chapter on " Internal Remedies" ) 
is most effective in reducing the swelling of the 
urethra and bringing about a quick recovery. 



84 GONORRHEA AND SEXUAL DEBILITY 



CHAPTEE XVHL 



LOCAL TREATMENT. 

There are three ways of applying remedies 
locally : 

First, by injections. 
Second, by irrigations. 
Third, by crayons. 

A— INJECTIONS. 

Injections are made with a small glass 
syringe. These latter are on the market in dif- 
ferent shapes, sizes and forms. Some are good 
and serviceable, others are useless. A good 
syringe should fulfil the following requirements: 

First, it should hold about two and one-half 
drachms. 

Second, it should have a glass barrel, so that 
its contents and cleanliness can easily be con- 
trolled. 

Third, its upper end should be of hard rubber. 

Fourth, its nozzle should be either of soft or, 
better, of hard rubber and have a blunt shape. A 
long drawn out nozzle should be rejected (see Fig- 
ure 12). 



BY DR. FERDINAND HERB. 



85 



Fifth, the washers should be of rubber or 
leather and slide easily in the barrel, so that in- 
jections can be made smoothly and without jerk- 
ing. 

Sixth, the washers should fit snugly, so that 
no medicine may leak above them. 



Figure 12. Syringe with blunt nozzle as recommended 
on the left; syringe with pointed nozzle as rejected on the 
right. 




Figure 13. All rubber syringe. 

Cheap glass syringes, which have thread as 
washer, are no good. The same is true of all 
rubber syringes, as shown in Figure 13. It is 
impossible to see if their barrel is clean, or if air 
is drawn in with the medicine. 

Care of Syringe. — The syringe must be kept 
perfectly clean. To carry it in a dirty vest pocket 



86 GONORRHEA AND SEXUAL DEBILITY 

without protection, as is done in many instances, 
is to invite dangerous infections. If the injection 
cannot be made at home and it is 1 necessary to 
carry the syringe on the person, it should be 
wrapped in a clean handkerchief or absorbent cot- 
ton. Wherever possible, the syringe should 
be cleaned with warm water every time before and 
after using. 

Filling of Syringe. — The best way to fill a 
syringe is to pour the medicine in a small glass 
or other container and draw it from there into 
the barrel. Although most medicines can safely 
be taken direct from the bottle, some will thus be 
spoiled. It is, therefore, best to avoid the risk. 

All air must be carefully expelled from the 
syringe. To this end, fill it, turn nozzle up and 
force piston in until all air is out. Then refill. 
Eepeat this procedure, if necessary, until the 
syringe is completely filled. 

How to Make Injections. — First pass urine. 
Never attempt an injection unless this is done 
immediately before. This is a fundamental rule. 
The urine brings out all slime and pus, contained 
in the canal, and prevents them from being carried 
with the injected fluid higher up into the urethra 
or bladder. After urination wash penis with soap 
and water, or, if this be impossible, clean it with 
dry absorbent cotton. Then take head of penis 
between second and middle finger of left hand, 
put syringe into mouth of urethra, and empty 
barrel under a steady and gentle pressure. The 
fluid should leave evenly and not in jerks. Never 
use force. Let the medicine take its way unim- 
peded. Neither obstruct its path by closing the 



BY DR. FERDINAND HERB. 87 

urethra with the finger in the middle or near 
the rectum, nor force it deeper by massaging the 
urethra towards the bladder. Both manipulations 
are apt to cause complications. 

When the fluid is all in, retain it the required 
time by either holding the nozzle in place or clos- 
ing the outlet of the urethra with the finger. Then 
allow the solution to escape. 

If it should happen that the medicine flows 
out in part before the proper time, let the rest go 
to. Then immediately make a second injection 
and hold this the prescribed length of time. 

Frequency of Injections. — Inject three to 
four times a day. Three times, once in the morn- 
ing after rising, once at noon and once in the 
evening immediately before going to bed, will do 
in most instances; but four injections daily are 
generally preferable. 

Length of Time the Medicine Should he Re- 
tained. — The time varies with different prepara- 
tions. Four to five minutes are, as a rule, suffici- 
ent, unless specifically stated otherwise. 

The Solution Should be Warm. — Warm solu- 
tions bring better results. The remedy, there- 
fore, had better first be warmed by either placing 
the bottle in warm water or filling the syringe half 
with a solution of double strength and half with 
hot water. 

Remedies. — The number of remedies recom- 
mended for the local treatment of gonorrhea is so 
great that it would be idle to attempt to give them 
all. Only the very best and most effective will 
here be enumerated and classified according to 
their usefulness. 



GONORRHEA AND SEXUAL DEBILITY 



In the case of a fresh, acute gonorrhea those 
remedies are best which are most effective in kill- 
ing the specific germ, the gonococcns. To this 
class belong numerous drugs which are endowed 
with strong germicidal power; but, above all, 
those preparations which contain silver in solu- 
ble form, as this element has the most destructive 
influence upon the disturbing microbe. 

Silver Nitrate has, therefore, for many, many- 
years been the main remedy for the cure of acute 
gonorrhea. But in spite of its usefulness, its 
many disadvantages could not be overlooked. To 
overcome these, great efforts have been made to 
find other, better silver compounds, which should 
possess all the advantages but none of the disad- 
vantages of Nitrate of Silver. The result has 
been the discovery of a number of most excellent 
chemicals, which are far superior to Nitrate of 
Silver. They contain a high percentage of active 
silver, are less irritating, and have a greater 
power of penetration. 

Of these, Eheno Silver Compound (Prescrip- 
tion 15) has given us the best satisfaction. It is 
very effective, does not irritate, does not smart, 
works well in nearly all cases, acute and chronic, 
and is in most instances the only remedy necessary 
to bring about a quick and permanent cure. 
Furthermore, it is marketed in such a way as to 
exclude all possibility of substitution. Silver in 
this form is a very expensive remedy, a fact which 
might tempt some dealers to substitute. It is, 
therefore, put up in vials, each containing suffici- 
ent material to make four ounces of medicine. 
The patient dissolves it himself and is, thus, 



BY DR. FERDINAND HERB. 89 

insured of the proper remedy and the proper 
strength. 

Prescription 15. 

Rheno Silver Compound 1 vial 

Dissolve in two to four ounces of water. 
Retain in urethra for twenty to twenty-five 
minutes. 

Another silver remedy is Protargol (Pre- 
scription 16). From ten to twenty grains are 
used to four ounces of water. As it is rather 
irritating, the patient should begin with a weak 
solution and increase strength as found desirable. 
No rubbing or shaking is neccesary to dissolve 
the drug. The solution is made by pouring the 
powder upon the water in the bottle and allowing 
it to stand until dissolved. 

Prescription 16. 

Protargol 10 (to 20) grains 

Distilled Water 4 ounces 

Pour powder upon water in bottle and 
allow to stand until dissolved. Retain in 
urethra for twenty to twenty-five minutes. 

Still another remedy is Argyrol (Prescrip- 
tion 17). It is also frequently prescribed, but 
usually less effective. 

Prescription 17. 

Argyrol 3 drachms 

Distilled Water 4 ounces 

Retain in urethra for twenty to twenty-five 
minutes. 

These preparations may be tried in the order 
of their enumeration. It will, however, rarely be 
found necessary to go to the second or third if the 
first is available. 



90 GONORRHEA AND SEXUAL DEBILITY 

As the effect of these three silver compounds 
is the greater, the longer they are in contact with 
the mucous membrane and the deeper they are 
allowed to penetrate, it is best to retain them in 
the urethra from twenty to twenty-five minutes. 

The use of the foregoing remedies should be 
continued so long as good and satisfactory pro- 
gress is made, at any rate for three to four weeks. 
It takes usually that long to kill the gonococci and 
to make them disappear from the discharge. And 
this is the first and principal object of a success- 
ful treatment. The time, however, necessary to 
accomplish this end may be longer or shorter. 
More accurate information is very desirable and 
can be had by means of a microscopical examina- 
tion of the pus, which offers the only means of 
knowing definitely. 

If, as may happen, these silver compounds 
do not take effect, one of the following drugs 
should be taken. They are also quite effective, 
but, as a rule, not as satisfactory in the end. 

These remedies are headed by Potassium 
Permanganate (Prescription 18). It is an old- 
time medicine and used, perhaps, more than any 

Prescription 18. 

Potassium Permanganate 

1 grain tablets, No. 25 

Reduce a tablet to powder and dissolve in 
three to four ounces of water. 

other. But although it suppresses the discharge 
quickly, yes, sometimes more quickly than the 
silver compounds, it does not equal the latter in 
efficiency, because it does not penetrate into the 
tissue, the hiding place of the gonococcus, and,. 



BY DR. FERDINAND HERB. 91 

therefore, cannot reach and overcome the con- 
tagion effectively. In consequence, cases are very 
much more in danger of becoming chronic and 
developing complications in the testicles, pros- 
tate gland and bladder if treated from the be- 
ginning only with Permanganate of Potassium. 

As 1 occasionally other remedies may be re- 
quired, some more are here given: 

Prescription 19. 

Corrosive Mercuric Chloride ... 7 3-10 grains 

Ammonium Chloride 7 7-10 grains 

Dissolve a tablet, containing the above 
remedies, in 16 ounces of water. Of this 
solution take one-half to one ounce and add 
water sufficient to make four ounces. 

Prescription 20. 

Mercuric Cyanide 2 (to 10) grains 

Distilled Water 4 ounces 

If the acute symptoms have disappeared; the 
discharge has diminished and changed from a 
thick, yellowish creamy to a thin, milkwhite or 
slimy consistency ; and, above all, if one can safely 
assume that the gonococci have been killed, — then, 
and not until then, is a change from antiseptics to 
astringents justified. 

Permanganate of Potassium (Prescription 
21) is again the first remedy to be mentioned, as it 
possesses not only antiseptic but also astringent 
properties. The objection raised against it before 
does not hold good in this stage of the treatment. 
It is now a most excellent and satisfactory remedy 
and well worth trying, that is 1 , after the gonococci 
have been removed. 



92 GONORRHEA AND SEXUAL DEBILITY 

Prescription 21. 

Potassium Permanganate 

1 grain tablets, No. 25 

Reduce one tablet to powder and dissolve 
in three to four ounces of water. 

The following remedy (Prescription 22) also 
is very good. It is the favorite of one of Ger- 
many's greatest specialists. 

Prescription 22. 

Zinc Phenolsuphonate 16 grains 

Resorcinol 50 grains 

Distilled Water, enough to make. . .4 ounces 

As a greater variety of remedies is required 
in this than in the acnte stage of the disease, a 
varied selection of approved remedies shall here 
follow : 

Prescription 23. 

Zinc Permanganate 2 (to 4) grains 

Distilled Water 4 ounces 

Prescription 24. 

Zinc Sulphate, 

Lead Acetate, each 2 (to 10) grains 

Distilled Water 4 ounces 

Prescription 25. 

Zinc Sulphate 2 (to 10) grains 

Bismuth Subnitrate, 

Powdered Acacia, each 1 drachm 

Distilled Water 4 ounces 

Prescription 26. 

Zinc Sulphate, 

Tannic Acid, each 2 (to 10) grains 

Distilled Water 4 ounces 

Prescription 27. 

Zinc Sulphate, 

Tannic Acid, each 2 (to 10) grains 

Fluidextract of Hydrastis, without alcohol . . 

3 drachms 
Distilled Water, enough to make ... 4 ounces 



BY DR. FERDINAND HERB. 93 

Prescription 28. 

Ichthyol Vz drachm 

Distilled Water 4 ounces 

Choice of Remedy. — Select Potassium Per- 
manganate (Prescription 21) to begin with, 
directly after the Silver Compound. If it does 
not stop the discharge, try Prescription 22. 
These two remedies will cure nearly every case of 
the later stage of gonorrhea, provided no stricture 
prevails. Occasionally one of the other medicines 
may do better. We have arranged them accord- 
ing to their effectiveness, as taught by experience. 
No cause can be assigned why a remedy works 
splendidly in one case and does not work in an- 
other apparently of exactly the same character. 
Experience is the best teacher. 

Change of Remedy. — A change of remedy is 
required if no decided improvement is noticed 
within a week or two, or if after an initial better- 
ment the progress comes to a standstill. It is to 
no purpose to continue indefinitely with the same 
remedy, hoping that it will finally cure. Change 
and try another! Enough prescriptions have 
been given to cure any and every case which is 
curable at all by injections. 

In very obstinate cases, strictures should be 
looked for and will usually be found. 

Strong Injections are Dangerous. — They 
cause strictures. Always start with a weak solu- 
tion and increase the strength as deemed suitable. 
Be guided by your feelings. No injection should 
cause real pain; if it does, it is too strong. A 
slight burning need not be heeded. 

Do Not Stop Injections Suddenly. — If this is 



GONORRHEA AND SEXUAL DEBILITY 



done, the discharge returns in many instances, as 
the sore within the urethra is healing, but not yet 
healed. Proceed as follows: If the discharge is 
all gone, that is, if neither during the day nor in 
the morning a visible quantity can be squeezed 
out, nor, upon rising, the lips of the urethra stick 
together, nevertheless continue to inject three 
times a day for a week. Then inject twice a day, 
upon rising and before going to bed, for another 
week; then once a day, before going to bed, for 
another week. Finally stop. If at any time dur- 
ing this period the slightest trace of discharge re- 
turns, inject again three times a day until the dis- 
charge has again disappeared; then do again as 
directed above. 



BY DR. FERDINAND HERB. 95 



CHAPTEE XIX. 



B.-IRRIGATION TREATMENT. 

Some years ago, Professor Janet, a Paris 
specialist of large experience, advocated the treat- 
ment of gonorrhea by irrigating the urethra and 
bladder with copious drafts of medicinal fluids. 
He claimed extraordinarily good results from this 
procedure, which has since been introduced and 
extensively used all over the world. 

These irrigations can be made in two differ- 
ent ways: 

First, by employing a catheter as described 
in Chapter 13, but using medicines instead of hot 
water. 

Second, by forcing the cut-off muscle of the 
bladder without using the catheter. 

To this latter method the following details 
refer. 

Instruments necessary: Syringe (Figure 14), 
or, better, glass tank (Figure 15) and nozzle, best 
made of glass and shaped according to the width 
of the mouth of the urethra (Figure 16, A, B, C). 

Proceed as follows: Prepare hands, instru- 
ments and penis as advised in Chapter 13. Fill 
syringe with solution ; hang it up at proper height ; 



% 



GONORRHEA AND SEXUAL DEBILITY 



attach nozzle ; sit down in position as described in 
Chapter 13 for hot water irrigation; take penis 
behind the head between thumb and index finger; 
allow cold water in the tube to escape; press noz- 




Figure 14. Fountain syringe. 

zle to penis and let medicine fill the bladder. Then 
remove nozzle, empty bladder and repeat the pro- 
cedure until syringe is empty. 





Figure 15. Two different kinds of Glass Tanks r 
either is good. 

That the bladder is full is indicated by an 
intense desire to urinate. 

The syringe must be hung four to six feet 



BY DR. FERDINAND HERB. 97 



above the level of the bladder. This for the fol- 
lowing reason: The nrine is held in the bladder 
by a cut-off muscle at the inner mouth of the 
urethra. This same muscle ordinarily also pre- 
vents the flow of water from the urethra into the 
bladder. To overcome its resistance, the pres- 
sure under which the remedy flows must be suf- 
ficient and is attained by hanging the syringe high 
enough. 



ID 



Figure 16. — Nozzles. A — for normal outlet; B — for 
very large outlet; C — for very small outlet. 

The pressure required is different with differ- 
ent persons and varies from practically nothing 
to a very high degree; that is to say, with some 
persons there is hardly any resistance on the part 
of this muscle; with others it may be impossible to 
overcome the obstruction. It may also happen that 
the muscle at first contracts violently, but soon 
relaxes after a few minutes of patient waiting. 

Irrigation of the Anterior Urethra. — It is some- 
times advisable, as for instance in fresh cases with 
plenty of creamy discharge, to irrigate but the 
front half of the canal. In this instance, the ure- 
thra is compressed at the junction of the body of 



98 



GONORRHEA AND SEXUAL DEBILITY 



the penis with the pouch of the testicles (Figure 
17) and the irrigator hung but two to four feet 
above the bladder to reduce the pressure. 




Figure 17. a — place where to compress urethra. 

MEDICINES.— The remedy mostly used is 
Potassium Permanganate, two to five grains in a 
quart of water. It is rarely required to go be- 
yond this limit. Tablets of any desired strength 
can be bought at any drug store. Those of one 
grain are handiest. If tablets of proper strength 
are not obtainable, if, for instance, two grains are 
desired and only five grain tablets are at hand, 
proceed thus : dissolve the five grain tablet in five 
ounces of water, throw three ounces away and use 
the rest for irrigation. 

The tablets dissolve very readily in hot water, 



BY DR. FERDINAND HERB. 99 

if they are crushed to a fine powder beforehand. 

It is advisable to commence with the weakest 
solution and begin irrigation with two grains of 
medicine to a quart of water. Although some 
smarting is unavoidable, strong pains should 
never arise. As the inflammation subsides and 
tolerance gets greater, the strength of the solution 
can be proportionately increased. A medium con- 
centration for the anterior urethra is five to ten 
grains, for the bladder four to five grains to a 
quart of water. 

If, after a week or ten days, no decided im- 
provement is evident, try a solution of Corrosive 
Sublimate, in the strength of 1:50,000 to 1:20,000. 

How to Prepare : Dissolve ten grains of Cor- 
rosive Sublimate in fifteen ounces of water. Of 
this solution use four teaspoonfuls to a quart of 
water on the first day; five teaspoonfuls on the 
second day; six teaspoonfuls on the third day, 
and so on until gradually eight to nine teaspoon- 
fuls to a quart of water have been reached, pro- 
vided, of course, that the solution is easily borne. 

A medicine glass, as obtainable at any drug 
store, must be used for measuring, as Corrosive 
Sublimate is decomposed if it comes in contact 
with a metal spoon. 

A combination of Potassium Permanganate 
with Corrosive Sublimate can also be tried. 

If these two remedies, either alone or in com- 
bination, have not the desired effect, try Silver 
Nitrate, in the strength of 1:5,000 to 1:2,500. 

How to Prepare : Dissolve one hundred grains 
of Silver Nitrate in fifteen ounces of distilled 
water. Of this solution use four teaspoonfuls to 
LOFC, 



100 GONORRHEA AND SEXUAL DEBILITY 

a quart of water on the first day ; five teaspoonf uls 
on the second day; six teaspoonf uls on the third 
day, and so on until gradually eight to nine tea- 
spoonfuls to a quart of water have been reached, 
provided again that the medicine is well borne. 
This solution, too, must be measured with a medi- 
cine glass for the same reason. 

How Often to Irrigate. — Irrigation of the 
anterior portion can be made twice a day, of the 
entire urethra once a day. 

Temperature of the Water. — The temperature 
of the water should be 115 to 125 degrees F., as 
found most suitable. 

Irrigation of Half or the Entire Urethra? — 
This depends on circumstances. So long as the 
disease is confined to the anterior urethra, as in 
the beginning of the disease, it is suflicient to irri- 
gate but this portion. If, however, the disease 
has already established itself near the bladder, the 
entire urethra must be washed out. 

An uneasy feeling along the penis near the 
rectum; any smarting sensation or pain near the 
neck of the bladder suggests a deep seat of the 
trouble. To find out definitely, proceed thus: 
Wash out anterior urethra as described above. 
Then urinate into glass. If first urine is muddy 
and turbid, the urethra near the bladder is affected 
and deep irrigations are called for. 

Injections or Irrigations? — We, on our part, 
have of late preferred injections for numerous 
reasons. Injections are much more easily made, 
need less time, less skill, and, above all, no trouble- 
some preparations. The cooking, boiling, steriliz- 
ing, etc., required for irrigation, if made properly, 



BY DR. FERDINAND HERB. 101 

consume a great deal of time and require a soft*, 
skillful hand, with which not everybody is en- 
dowed. 

As yet, many physicians are greatly in favor 
of irrigation. Their number, however, is dimin- 
ishing rapidly, as the introduction of the newer 
silver compounds has given us means to combat 
gonorrhea in a less troublesome and more effective 
way. 

We, therefore, advise injections for the aver- 
age person and leave irrigation for those who see 
fit to observe all those precautions necessary for 
this operation. 

C— UEETHEAL SUPPOSITOEIES OR 
CRAYONS. 

These are long, thin sticks made of Cocoa 
Butter in which medicines have been incorporated. 
They are being used extensively by some physi- 
cians. Further details are, however, here omitted 
as injections and irrigations are better. 



102 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XX. 



INTERNAL REMEDIES. 

We have already referred to some internal 
remedies in Chapter 15. They belong to the class 
of urinary antiseptics and are valuable at any 
time during a siege of gonorrhea. 

Exalted claims have been made for some of 
them, for instance, Methylene Blue. Dr. J. Moore 
reports in the British Medical Journal 1897, page 
140, remarkable cures with this remedy, using 
three grains three times a day. Although we have 
employed it in nearly all of our cases, we have 
never been able to realize such splendid results; 
but we have seen enough of its good work to recom- 
mend this drug heartily to all patients, not, how- 
ever, as an only remedy, but as an adjunct to the 
regular treatment. 

Methylene Blue is best taken in the form of 
tablets, as given in Prescription 29. 

Prescription 29. 

Methylene Blue, 

Nutmeg, each 2 grains 

Made into tablet, pill or capsule. One 
three times a day. 

Let us here reiterate that the combination of 
Methylene Blue with balsamic remedies is not to 



BY DR. FERDINAND HERB. 103 

be recommended for the reason that Methylene 
Blue is harmless and always serviceable; balsamic 
remedies are not, as we shall see later. If both 
are used at the same time, they had better be taken 
separately. 

Salicylate of Sodium has also proved of bene- 
fit in a number of instances. The dose is 16 to 20 
grains 1 three times a day after meals (Prescription 
30). 

Prescription 30. 

Sodium Salicylate 1 ounce 

Water, enough to make 4 ounces 

One teaspoonful three times a day after 
meals. 

Balsamic Remedies. — Balsamic remedies, we 
believe, play a very unimportant part in the essen- 
tial treatment of the acute stage of gonorrhea, 
but do much to make the patient comfortable. 
They have their advantages, but also their limita- 
tions. They render an irritating urine neutral, 
soothe and cool the inflamed membrane, remove 
many unpleasant and distressing sensations, but 
they do not kill the gonococcus. The result is that 
many a case of gonorrhea becomes thus chronic. 
If used indiscriminately, they are, further, the 
cause of many an incurable chronic kidney disease. 
We have treated scores of men who, misled by 
friends, druggists, patent medicine manufacturers, 
advertising quacks, or worthless books, spurned 
injections and for weeks and months faithfully 
used balsamics and oils ; but finally sought medical 
advice, their digestion ruined, their kidneys im- 
paired, their urethras full of strictures and — the 
gonococcus still in their scanty but obstinate 
discharge. 



104 GONORRHEA AND SEXUAL DEBILITY 

Balsamic remedies are, therefore, not always 
a blessing; they may, if improperly used, be a 
curse. 

We admit, and no one will deny, that balsamic 
remedies reduce the discharge. But is this always 
desirable! To answer this question, let us look 
at the daily experience. It is a well-known fact 
that cases of gonorrhea which, from the begin- 
ning, discharge slightly and seem to be of a mild- 
nature, often in the end prove most obstinate and 
insidious and are frequently followed by stric- 
tures and other complications; while many other 
cases, which discharge very profusely, heal com- 
pletely in a remarkably short time. How does this 
come? The explanation is this: The discharge 
is one of the means by which Nature tries to rid 
the body of her enemies. In infectious diseases 
of the bowels we see a parallel condition, vomiting 
and diarrhea being here resorted to by Nature to 
free the intestines from the poisonous material. 
Everyone knows that it is dangerous to check the 
diarrhea before the poisons are out. So it is with 
the gonorrheal discharge. In the initial stages it 
is swarming with gonococci, millions upon millions 
being thus thrown off. Its creamy character is a 
sign that Nature is fighting a mighty battle with 
the besieging microbe, the white blood corpuscles, 
which form the pus, representing but the dead 
soldiers on the battle field. If, therefore, we re- 
duce the discharge at a time when the gonococcus 
is still present in large numbers, we break down 
the line of defense put up against it and help it 
to penetrate into those hiding places from which 
it can be expelled only with the greatest difficulty. 



BY DR. FERDINAND HERB. 105 

These facts will help us to appreciate the 
claims 1 of Professor Fournier, one of the greatest 
French specialists on sexual diseases, who asserts 
that balsamic remedies are the cause of nearly 
eighty per cent, of all cases of gleet. He may be 
right or wrong, the fact remains that the reduc- 
tion of the discharge without the destruction of 
the gonococcus cannot be a benefit, but must be a 
detriment. 




Figure 18. Pus under the microscope. The globules 
represent white blood corpuscles. They are the individual 
soldiers sent out by the system to combat the attacking 
microbes. Those killed in this battle by the poisonous 
secretions of the enemy are cast off by Nature as pus. 

It will be very instructive to cite at this junc- 
ture the experience of Dr. H. Saar, assistant in 
the Dermatological Clinic of the University of Bres- 



106 GONORRHEA AND SEXUAL DEBILITY 

lau, Germany (Mnenchener Medicinische TTochen- 
sckrift 1905, page 2221). For a test, he treated 
fifty cases of gonorrhea with Oil of Santal only. 
After elucidating the results as to other points, he 
continues: "Above all, the reaction of the gon- 
ococcus was of interest. Every second or third 
day a microscopical examination was made. In 
six cases, that is, twelve per cent., the gonococcus 
disappeared. In all other cases, that is, eighty- 
eight per cent., gonococci were found and often in 
great numbers, though the secretion was frequent- 
ly very slight or entirely absent and only filaments 
(see "Chronic Gonorrhea") were present in the 
urine. Supported, therefore, by these tests, I 
must warn against an exclusive treatment with 
balsamic remedies." 

A short comment may be allowed. Eighty- 
eight per cent, of his cases presented the gonococ- 
cus after a thorough treatment with Oil of Santal, 
though many of them, to outward appearances, 
were cured. This means, that these eighty-eight 
per cent, were still infectious, a menace to them- 
selves, to their families, to the community, in spite 
of the fact that many of them seemed to be per- 
fectly well. In other words, the Oil of Santal had 
simply covered that dangerous pit "infection" 
with brush and straw and allowed it to remain a 
deadly trap for the diseased and his innocent 
victims. 

Do you, reader, still wonder why we call bal- 
samic remedies a curse, if improperly used? Is 
not an enemy infinitely more dangerous if he sends 
his poisonous missiles upon the unsuspecting from 
an invisible position in ambush? Let us, there- 



BY DR. FERDINAND HERB. 107 

fore, urge upon men to heed these lessons in the 
interest of their unborn children, in the interest 
of their present and future wives. There is misery 
enough on this globe without plunging into more 
with open eyes. 

It is, however, an entirely different matter if 
the discharge is reduced by gonococci-killing 
agents, as the silver compounds; for if the cause 
is removed, the effect naturally disappears in con- 
sequence. 

Balsamic remedies should, therefore, not be 
used except: 

First, in the acute stage of gonorrhea, if 
chordee is very distressing, the pain during urina- 
tion is very severe and cutting, and urination be- 
comes difficult on account of the swelling of the 
mucous membrane of the urethra. As soon aa 
the most distressing symptons are relieved, the 
remedies should be suspended, until: 

Second, in the later stage, if it remains to 
stop that slimy, mattery discharge which in some 
cases is still present after the gonococci have been 
killed by other means. 

Of the great number of balsamic remedies, 
only three are worthy of mention: Oil of Santal, 
Copaiba and Cubeb. 

Oil of Santal (Prescription 31) is the best. 
It is the most efficient of its class and least objec- 
tionable to the stomach. These two properties 
give it the preference over the others. 

Prescription 31. 

Oil of Santal 2 ounces 

Fifteen to thirty minims three times a day 
after meals. 



108 GONORRHEA AND SEXUAL DEBILITY 

However, the oil, if pure, is very expensive 
and, therefore, usually adulterated, in spite of all 
drug legislation. The cheaper the oil is sold, the 
surer a patient can be that he is not getting what 
he asks for. The only way to guard against sub- 
stitution is to buy in original packages of a reli- 
able firm. 

The same is true of oils put up in capsules, 
usually containing five to ten minims. 

Combinations of Oil of Santal with other bal- 
samic s or chemicals, such as Salol, Pepsin, etc., 
offer no advantage. 

Copaiba. — Its dose is from twenty to forty 
minims three times a day. It is less expensive 
than Oil of Santal, but just as often adulterated. 

Prescription 32. 

Copaiba 2 ounces 

Fifteen to thirty minims three times a day 
after meals. 

Copaiba is by no means a remedy pleasant to 
take. Furthermore, it is very annoying to the 
stomach and frequently causes loss of appetite, 
belching, vomiting, and other dyspeptic symptoms. 
Skin eruptions also are frequently occasioned by 
it. They come with fever and itch and burn. 
More serious is the irritation of the kidneys, which 
may follow the prolonged use of this remedy and 
occasionally turns into Bright 's disease. 

Cubeb. — It may be taken in the form of pow- 
der (Prescription 33), but is more convenient in 
the form of oil or oleoresin (Prescriptions 34 and 
35). 



BY DR. FERDINAND HERB. 109 

Prescription 33. 

Cubeb, powdered 3 ounces 

One to one and one-half drachms (heaping 
teaspoonful) three to four times a day after 
meals. 

Prescription 34. 

Oil of Cubeb 2 ounces 

Ten to fifteen minims three times a day- 
after meals. 

Prescription 35. 

Oleoresin of Cubeb 2 ounces 

Ten to fifteen minims three times a day- 
after meals. 

Cubeb is rarely taken alone, bnt usually in 
combination with copaiba. Capsules, soft and 
hard, small and big, are on the market. They are 
all good so long as the drug is pure. As to the 
number of capsules to the dose, the patient may 
be guided by comparing the quantity in the cap- 
sule with the dose given above. 

In order to attain the best possible results, 
one should push the dose quickly to the highest 
possible limit, continue thus 1 for ten to twelve days 
and gradually again fall off. If, at the end, the 
discharge is not yet gone, it is best to wait for six 
to ten days and repeat the treatment. This is 
better in every way than to take the medicine con- 
tinually. 

If, when using balsamic remedies, any of the 
above mentioned ill by-effects appear, such as 
stomach trouble, skin eruption, irritation of the 
kidneys, pains in the back, general weakness, etc., 
the remedy should at once be discontinued, as it 
does more harm than good under such circum- 
stances. 



J 10 GONORRHEA AND SEXUAL DEBILITY 

To forestall kidney disease, we urgently 
recommend to examine the urine frequently for 
albumen while taking balsamics. The patient can 
do it easily himself, if he will but follow the 
instructions given in the last chapter. 

Local or Internal Treatment? — There can be 
no choice. Both are essential in their proper 
place. We, therefore, urgently recommend in- 
jections with one of the silver solutions and, in 
support of the local treatment, internal remedies 
at such times as advised on the foregoing pages. 
This is the best, the only safe, way in spite of all 
claims to the contrary. 



BY DR. FERDINAND HERB. 1 1 1 



CHAPTER XXI. 



DURATION OF SIMPLE GONORRHEA. 

The duration of gonorrhea varies consider- 
ably in different cases 1 , bnt all experts agree that 
the average is about six weeks. This is also our 
experience; though, more recently, the time has 
been somewhat shortened through the use of the 
new silver compounds. However, a great many 
cases recover sooner, that is, in three to five weeks ; 
a smaller percentage does not see the end of the 
disease until after as many months, and some un- 
fortunates have to suffer for many years before 
health returns. It all depends, first, on the 
severity of the infection; second, on the mode of 
life and habit of the patient, and, last, but not 
least, on the conscientiousness with which the 
treatment is carried out. 

Cases healing in a week or two are usually 
of no specific character and not caused by the 
gonococcus (see Chapter 10). They are often 
pointed to as proof that ' ' a clap is not as bad as a 
cold." In contrast to this unfortunate belief, we 
will cite here Ricord, the French specialist, to 
whom we have referred in our "Historical Intro- 
duction," — a man of the widest experience. He 
drastically expresses his pessimistic mood in the 
words : " A clap begins and God alone knows when 
it ends." 



1 12 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXn. 



CHRONIC GONORRHEA. 

By chronic gonorrhea or gleet is understood a 
condition of chronic inflammation of the mncons 
membrane of the nrethra. It is left as a conse- 
quence of an acute inflammation. Just when the 
acute stage is over and the chronic one begins is 
difficult to decide and a more or less arbitrary 
matter. But as the average attack of an acute 
gonorrhea lasts about six weeks, the medical pro- 
fession generally terms " chronic' ' all those cases 
which last longer than about twice this time, that 
is, longer than two to three months. 

Why in some instances the acute gonorrhea 
heals promptly, while in others it is obstinate and 
refractory, turning over into the chronic state, 
cannot be determined in every instance. It is, 
however, certain that neglect of treatment, im- 
proper treatment, improper diet, too great exer- 
tion, and, very frequently, the improper use of bal- 
samic remedies, tend to make a case chronic. But 
there are instances where the case gets chronic in 
spite of the most skillful treatment and proper 
care. The character of the infecting microbe, the 
nature of the one infected, and other uncontrol- 



BY DR. FERDINAND HERB. 113 



lable circumstances, are the determining factors. 

Symptoms. — The symptoms of chronic gon- 
orrhea or gleet resemble those of the later 
weeks of the acute stage. There is comparatively 
little discharge, sometimes so much that a drop 
or two can be squeezed out at any time of the day, 
sometimes so little that only a slight oozing 
appears or the lips of the urethra are stuck to- 
gether in the morning. At times, however, the 
discharge is more profuse on account of an aggra- 
vation of the inflammation, caused by the use of 
alcoholic stimulants, improper diet, sexual excite- 
ment, night emissions, or over-exertions, such as 
horse back riding, bicycling, dancing, etc. 

The discharge is of slimy-mattery character, 
glue-like, tenacious, stringy and ropy, and its 
color from milky-white to a muddy gray. 

Shreds or Filaments. — Those afflicted with 
chronic gonorrhea, and a great many others who 
have apparently completely recovered from the 
disease, can find in the first gush of urine, passed 
in a bottle or glass, more or less numerous float- 
ers, so-called "Shreds or Filaments." They are 
of different sizes and figurations, some like little 
short crumbs, others like long drawn out threads, 
some heavy and sinking quickly, others light and 
floating a long time, some milky-white, others 
transparent, glassy in appearance. 

Shreds originate either from open unhealed 
places in the urethra or come from the interior 
of the many glands which empty into this canal. 
In both instances, they are witnesses to the fact 
that the diseased membrane has not yet returned 
to a perfectly normal condition. 



1 14 GONORRHEA AND SEXUAL DEBILITY 

This does not mean to say that all those who 
have shreds in their urine continue to have gon- 
orrhea. By no means! Many, very many, of 
those who are perfectly cured in the ordinary 
sense of the word, who feel well, have healthy 
wives and healthy children, can find these shreds 
after year, yes, tens of years, of perfect health. 
Experience has shown under such circumstances 
that they are innocent remains of a former infec- 
tion. 

But not always can one trust to the inno- 
cence of shreds. They are often the poisonous 
missiles which spread ruin and death insidiously. 
For they carry the gonococci, if there be any left 
in the urinary canal. 

Shreds should, therefore, always be taken as 
a danger signal and warning. If they are present 
in great numbers, it is best to take it for granted 
that a chronic gonorrhea remains in spite of the 
absence of discharge. We find these conditions 
principally in cases treated with balsamic reme- 
dies. The discharge is gone, but shreds, loaded 
with gonococci, threaten the innocent bride or 
wife, as the bullet of the lurking brigand threatens 
the unsuspecting traveler. 

The same condition of affairs, that is, infec- 
tiousness, but in a less degree, may exist though 
the shreds be less numerous and less bulky. If 
gonococci are present, there is danger; if gon- 
ococci are absent, there is no danger. 

A repeated microscopical or bacteriological 
examination is required to arrive at a decision. 

With the exception of the discharge or shreds, 
there is usually no sign of illness. Urination may 



BY DR. FERDINAND HERB. 115 

occasionally smart slightly, especially after an 
excess in wine or Venns, but there is rarely any 
severe pain. Nor need there be any other molesta- 
tion which might remind one of the existence of 
the disease. And yet, below the apparently un- 
ruffled surface lurks the gonococcus, the arch 
enemy of the human race, patiently waiting for 
his chance to be transplanted and to bring misery 
and destruction to more victims of his rage. 

Course. — The course of chronic gonorrhea 
is, as a rule, rather tedious. No definite time of 
its duration can be set. Though most cases yield 
to proper treatment nicely, there are some which, 
on account of complications, wear out patient and 
physician. Acute aggravations often interrupt 
the monotony and are frequently mistaken for 
fresh infections. 

Treatment. — Rest.— Best is not so essential 
in chronic gonorrhea as it is in an acute attack. 
On the contrary! Moderate outdoor exercise re- 
freshes mind and body and helps to conquer the 
disease. But over-exertion, horse back riding, 
bicycling and violent sports are harmful. 

Diet. — Nor need the diet be so much restrict- 
ed. A limited use of light alcoholic beverages, 
such as a glass of light wine, is permissible, should 
the craving therefore be very pronounced. In this 
connection it may be said that it is less harmful 
to take alcoholic stimulants in moderate amounts 
regularly, than to indulge in them occasionally. 
Excesses, of course, are always harmful and are 
usually followed by an aggravation of the 
symptoms. 

Local Cleanliness and Cleanliness of the 



1 16 GONORRHEA AND SEXUAL DEBILITY 

Hands. — As to these we refer to a former chapter. 
There is no difference whether the gonorrhea be 
acute or chronic. The discharge is always dan- 
gerous to the eyes and to other persons so long 
as the gonococcus is present therein. 

Sexual Relations. — Sexual relations are, 
of course, strictly forbidden. They do not only 
severely harm the patient himself, but also expose 
others to infection, as chronic gonorrhea, too, is 
communicable in most instances. 

Local Treatment. — The local treatment of 
gleet is far more difficult, and requires much 
more patience, than that of acute gonorrhea. 

Injections. — Injections are also here of prime 
importance so long as gonococci are present. To 
decide this, a microscopical examination of the 
discharge must be made. Should this be impos- 
sible, it is best to assume that the contagion is still 
active if no silver compounds have as yet been 
used. Accordingly, a course of treatment with 
one of these remedies had better be undertaken. 
If no complications exist, Eheno Silver Compound 
usually effects the cure. If the case proves stub- 
born, it is best to continue the silver remedy for 
about four weeks and, then, select one of the 
astringents given for the later stages of acute 
gonorrhea. They are also good for chronic cases, 
provided they are used in somewhat greater 
strength, but not so strong as to cause pain. 

Irrigations with medicines can be tried 
if injections fail. They are made as in acute 
gonorrhea, the greater concentrations being rather 
preferable. 

Application of Heat. — As an increased 



BY DR. FERDINAND HERB. 1 1 7 

flow of healthy blood has a very favorable 
influence upon the healing of any chronic ailment, 
wherever located, efforts are of late being made 
to profit from this fact in lingering gonorrheal 
affections by the application of heat. The advan- 
tages are two-feld: 

First, the greater afflux of blood forces the 
gonococci from the deeper layers of the tissue 
closer to, or into, the canal of the urethra, that is, 
nearer, or into, the sphere of antiseptic remedies. 
This makes gonococci-killing medicines more 
effective. 

Second, the heat itself is deleterious to the 
germs as we have explained in Chapter 13. 

The application of heat in any of the forms 
described in Chapter 13 is, therefore, of great 
value in most chronic cases 1 and frequently helps 
where all other efforts have failed. Irrigations 
are particularly beneficial. 

If the bladder is not infected, the catheter 
had best be used; if it is affected, the other form 
of irrigation is best. Instead of clear water, the 
weakest of those irrigating fluids given in Chapter 
19 can also be used. This may in some instances 
be of advantage, but the heat is more important 
than the medicine. 

To give cut and dried rules is impossible, as 
every case has its own peculiarities. All we can 
do is to direct along general lines, expecting from 
those who attempt the treatment to work out the 
details to suit their own particular case. 

Internal Remedies. — The use of internal 
remedies in full doses should be begun as 
soon as it has been ascertained by microscopical 



1 18 GONORRHEA AND SEXUAL DEBILITY 

examination, or can reasonably be expected (as 
after four to five weeks of silver treatment) that 
the specific germs have been eliminated. These 
medicines (see Chapter 20) are then proper and 
often work admirably. Local astringents may, or 
may not, be used at the same time. A little re- 
flection will soon determine the proper action in 
every instance. 



BY DR. FERDINAND HERB. . 119 



CHAPTER XXIII. 



OBSTINATE CASES. 



There are instances 1 where patients faithfully 
and diligently try their very best to effect a cure^ 
but without success. The discharge does not 
stop. With unfailing punctuality it is there, upon 
rising, and says its "good morning,' ' as the 
Frenchman wittily remarks. 

Under such circumstances we advise a tem- 
porary discontinuance of all local treatment. It 
sometimes happens that the very irritation of the 
urethra, the treatment is supposed to allay, is 
thereby continued and the discharge perpetuated. 
Then, the stopping of the injection will cure the 
case. Thus it may chance that a patient, weary 
and disgusted with the never ending annoyance, 
quits his physician, stops treatment, and slowly, 
but surely, loses his discharge. It is in such cases 
that, even with fair-minded and reasonable per- 
sons, suspicion may arise that the medical attend- 
ant intentionally kept the disease afresh. But 
this charge, we must say, is without justification, 
since such incidents may happen to the most faith- 
ful and conscientious physician. 

If, however, after due time no improvement 



120 GONORRHEA AND SEXUAL DEBILITY 



follows, or, yea, the discharge increases or other 
symptoms of aggravation appear, it is safe to con- 
clude that complications exist. These nmst be 
located and treated according to their nature. 

WHEN TO MARRY?— Deciding this question, 
we must ask: "Is there any possibility left to in- 
fect others ?" and further: "What are the out- 
ward signs of such possibility f " 

The possibility to infect others remains so 
long as gonococci are present in the urethra or 
its neighboring organs, and the outward signs that 
this is, or may be, the case are discharge or shreds. 

A microscopical examination is, therefore, 
not always necessary to decide the question of 
marriage. If a patient has been properly treated; 
the discharge has ceased entirely for some time, 
say several months ; the urine is clear and no fila- 
ments or shreds are in its first portion, — the 
patient may safely marry without fear or scruples. 

In all other cases the opposite obtains. It 
does not require the existence of a daily or occa- 
sional discharge; it does not require the scanty 
secretion just sufficient to stick the urethral lips 
together during sleep, — the presence of shreds in 
the urine, without any further evidence of disease, 
is sufficient to call for minute scrutiny. It is in 
these shreds that the gonococcus is transferred, as 
they contain the germ, if there is any in the 
urinary tract. 

Happily, however, the presence of filaments 
or shreds is not always a conclusive proof that 
the case is infectious. The number of those who 
present filaments in the urine after a case of 
gonorrhea is so great that it would be ruinous to 



BY DR. FERDINAND HERB. 121 

the propagation of the race to exclude them all 
from marriage. Nor is it necessary to do so. Not 
every one who produces filaments harbors specific 
germs. Many shreds are harmless and contain no 
gonococci. But how to know this? How to de- 
cide which shreds do carry infection, and which 
do not? 

Under such circumstances, a microscopical or 
bacteriological test becomes indispensable. This 
means that the filaments must be examined under 
the microscope and eventually also an attempt be 
made to demonstrate the microbes by growing 
them on suitable soil. 

The latter procedure is extremely difficult, but 
the most conclusive ; the former requires less skill 
and less time, but is also less satisfactory, though 
it is the only method usually employed. 

In order to come to a definite conclusion, both 
tests must be repeated a number of times, as the 
failure to find the germ in but one test is no con- 
vincing proof that it is not present. But when 
four to six thorough-going examinations have been 
made and all fail to disclose the elusive microbe, 
the conclusion is justified that it is not there. 

In those cases where there still exists a visible 
discharge; or where the urethral lips are glued 
together in the morning; or where upon provoca- 
tion, sexual or alcoholic, there again re-appears a 
little mattery moisture at the outlet of the 
urethra; or where there are dull discomforting 
sensations near the rectum upon the same occa- 
sions, — the above cumbersome examinations need 
hardly be made. One may at once come to the 
conclusion that the case is still infectious and the 



122 GONORRHEA AND SEXUAL DEBILITY 

disease communicable. This we say in spite of 
the fact that there are cases with the above symp- 
toms that are not infectious. But these instances 
are the exceptions and it is far, far better to err 
on the side of overcaution than to take a dan- 
gerous risk. 

We know that a certain percentage of our 
readers will turn a deaf ear to our admonitions. 
These always have lived, and always will live, a 
careless life. They will not bother with examina- 
tions of shreds and filaments, nor wait with mar- 
riage; they take their chances, however frightful 
the consequences — to others. Nor are these reck- 
less members of human society by any means con- 
fined to the lower walks of life. They are also 
frequently found among the upper and the highest 
classes. They must be reckoned with and taken 
care of. The following advice given by Dr. 
Kromayer (Muenchener Medicinische Wochen- 
schrift No. 24, 1898) will not be amiss for them, 
but should also be heeded by all those who have 
shreds in their urine, however harmless in 
appearance. 

" First: Urinate immediately before sexual 
congress to expel any secretion that may have 
accumulated in the urethra. ' ' 

"Second: Avoid as much as possible having 
intercourse oftener than once a day." 

"Third: Never perform the act twice in suc- 
cession, because, if the first seminal discharge con- 
tains gonococci, the friction attending the second 
coitus brings them into closer contact with the 
urethra and the mouth of the womb, thereby in- 
creasing the danger of infection." 



BY DR. FERDINAND HERB. 123 

"If this rule is disregarded, and the act is 
performed more than once in twenty-four hours, 
the vagina should be thoroughly flushed out with a 
vaginal douche, which should, in general, be em- 
ployed as often as possible. ' ' 

A few words more. We have on several occa- 
sions mentioned a class of medical practitioners 
who, from total ignorance as to the nature of gon- 
orrhea and the terrible effects of the gonococcus 
upon women, or from sheer carelessness, allow 
patients to marry even before the "morning drop" 
has disappeared. Beware of them! No act is 
more brutal, more debased, yes, more criminal, 
than to carelessly expose to life-long misery or 
death an innocent woman, who sees in marriage 
the glory of her future and with confiding soul 
submits to her marital duties only to find herself 
sullied in her bridal-night with a loathsome 
disease. Of what avail are all vain regrets? The 
damage is done and cannot be repaired. The only 
consolation, left to the unfortunate husband, — and 
it is a flimsy one, indeed, — is the placing of the 
responsibility. And therein we agree with Jullien, 
who says: "Should the qualification 'guilty' be 
applied to the large number of men who uncon- 
sciously soil their wives at the first approach? 
When the responsibilities are well examined into, 
it is to the neglect or incompetence of the physi- 
cian that they should be ascribed. If he has made 
an insufficient examination, if he has been satis- 
fied with a rapid inspection, he alone is guilty.' ' 



124 GONORRHEA AND SEXUAL DEBILITY 



CHAPTEE XXIV. 



STRICTURES. 



We, here, arrive at the most frequent and, per- 
haps, most troublesome complication of gonorrhea. 
Be it, however, understood that by "most trouble- 
some" we do not mean the most troublesome as to 
local annoyances, but as to far reaching conse- 
quences upon the entire organism. 

What is a Stricture? — The urethra, the 
conduit for the urine, is a canal, the walls of 
which are soft, pliable and elastic. If at any 
point in its course there exists an obstruction, 
which narrows the passage or makes the walls less 
pliable and unelastic — we call it a stricture. In 
other words : A stricture is an obstruction within 
the urethra, It is mostly of scarry nature. In 
this instance, it has, like any other scar, the 
tendency to shrink and to thereby gradually 
encroach upon the urinary canal. Behind the 
stricture, that is, towards the bladder, the urethra 
is usually widened in consequence of the pressure 
exerted by the bladder to force the urine through 
the narrow passage (see Figure 19). 

Causes. — Gonorrhea is the cause of strictures 
in 80 to 90 per cent, of all cases. 



BY DR. FERDINAND HERB. 125 

Self-abuse comes second in importance, 
especially if practised in early youth and fre- 
quently. 

Injuries come third. 

In a number of instances no cause can be as- 
signed. 




. a 



Figure 19. a — Widened place behind the stricture, 
lying towards the bladder. 

Different Kind of Strictures. — Not all 
strictures are alike. In some instances the 
stricture is hard and tough, the remains of a 
sore healed with a firm and solid scar. In other 
instances, it is partly hard and partly soft. This 
happens if the sore heals but imperfectly, that is, 
if its front part, lying towards the outside, forms 
a scar, while the back part, lying towards the blad- 
der, remains open and discharges (Figure 20). 
In still other instances, the stricture is not formed 
by a scar but by a chronic swelling and infiltra- 
tion of the tissue beneath the mucous membrane 
(Figure 20 a) or by a granular growth like proud 
flesh. 

Their Number varies. Sometimes there is 
but one, sometimes there are two or three, and 
sometimes so many that the entire urethra from 
one end to another is studded with them. 



126 



GONORRHEA AND SEXUAL DEBILITY 



Their location may be in any part of the 
urethra. However, they are oftener found in the 
deeper than in the front part of the canal. Their 
favorite place is near the bladder. 




Figure 20. a— open sore behind the stricture, lying 
towards the bladder. 



sgp^ 



Figure 20a, a — stricture caused by an infiltration be- 
neath the mucous membrane and not by a scar. 

Their form also varies greatly. It may be 
that of a period, or of a comma, or a half moon, 
or a circle, or even that of a corkscrew. The 
more extensive they are, the more dangerous they 
must be considered. 

Why do Strictures Develop in One Case and 
Not in Another? — Some causes are known. To 
these belong: Too strong injections. These lat- 
ter are used sometimes ignorantly, sometimes in- 
tentionally in the mistaken belief that the stronger 
the injection, the quicker the cure of gonorrhea. 



BY DR. FERDINAND HERB. 127 

Another cause is a protracted course of the 
disease. Everything that tends to delay the heal- 
ing, such as improper conduct, improper treat- 
ment, sexual indulgence, and especially the un- 
timely use of balsamic remedies, — also tend to 
produce strictures. 



5 
| 


^ 


/ 


V 


1 * 


4. 


c 



Figure 21. — Forms of Strictures. a — Stricture in the 
form of a dot; b — Stricture half encircling the urethra; 
c — Stricture encircling the urethra. 

There is no better preventive than a mild sil- 
ver injection in the beginning of the trouble and 
the elimination of the gonococcus at the earliest 
possible moment. The longer the gonorrhea lasts, 
the greater is the chance for a stricture. In 
chronic cases of gleet, the development of a 
stricture is, therefore, a common occurrence and 
should always be searched for promptly. 

Symptoms . — Discharge. — Sometimes there is 
discharge, sometimes not. This depends upon 
the condition of the original sore. If it 
is perfectly healed and nothing left but a solid 
scar, no discharge exists ; but if it is healed only 
partly and is still suppurating, there will be a 
discharge. 

If there is discharge, the case does not, to out- 
ward appearances, differ from common gleet. 
The oozing may be daily or occasionally, may be 



128 GONORRHEA AND SEXUAL DEBILITY 

greater or less, and urinating smarting and burn- 
ing one day and painless the next. In fact, as 
gleet and stricture are usually associated and go 
hand in hand, they blend their symptoms, so that 
nothing short of an instrumental examination 
will make it possible to decide whether a stricture 
exists or not. 

If there is no discharge, there may be shreds, 
more or less, as evidence that some pathological 
process is still going on in the depth of the 
urethra. But also these may be absent and noth- 
ing indicate the insiduous disease but a slowly 
increasing difficulty in urination, a failing sexual 
power, or nervous symptoms of general character. 

Frequency of Urination. — The frequency 
of urination changes with changing conditions. 
On some days it is very great, on others less, 
depending on the degree of irritation present. 
This increase of the desire to urinate is one of the 
most common symptoms of stricture, but is usually 
attributed to disease of the kidney. 

Change in the Stream. — The stream need 
not, and usually is not, changed in the case 
of slight strictures. The urine flows easily and r 
apparently, without hindrance. Gradually, how- 
ever, as the canal narrows, it becomes smaller, 
irregular, forked, twisted and turned. The last 
drops are usually retained and run out later, wet- 
ting the shirt. Slowly the difficulty increases. 
It takes a little time and requires some pressure 
to empty the bladder. The force is diminished, 
the bow grows smaller and finally fails and the 
urine drips from the outlet. 

If no relief is sought, at last those unfor- 



BY DR. FERDINAND HERB. 129 

tunate conditions develop where urination is ex- 
tremely difficult, the bladder distends and inflames, 
the kidneys become involved, and the desire to 
pass water is almost continuous. 

The symptoms portrayed above, usually grow 
worse slowly, sometimes very slowly. It may re- 
quire many, even ten to twenty, years for their 
full development. So it may happen that the 
original cause, from which the present trouble 
comes, has been entirely forgotten, particularly if 
it was of light nature. Under such circumstances 
memory is refreshed with difficulty. Frequently 
the physician must question for a long time until 
he finally succeeds in recalling to mind a long for- 
gotten, trifling discharge some five, ten or twenty 
years back, to the utter amazement of the patient, 
who will not, or cannot, understand that this 
" paltry affair of his younger days" underlies his 
present ailment. And yet it does! Vengeance 
sometimes comes late, and many a man has, after 
reaching the age of 40, 50 or even 60, paid the 
penalty for sins perpetrated in his youth. 

But the progress is not always slow. The 
complete stoppage of urine may come on sud- 
denly like a bolt from a clear sky. Physical over- 
exertion or excesses in wine or women may cause 
an already existing, but so far unobstructive, 
stricture to suddenly swell so much that the urin- 
ary canal becomes completely closed. Eelief 
either comes of itself in a few hours or must be 
brought about by artificial means (see Chapter 
17). 

Effects_ on Sexual Capacity and Procre- 
ation. — These are not wanting in a goodly 



130 GONORRHEA AND SEXUAL DEBILITY 

percentage of cases. The erections are dis- 
comforting, the emissions painful; the semen, 
instead of leaving in forceful jets, lingers in the 
urethra and dribbles and oozes out, or is forced 
back into the bladder and discharged with the 
next urine, which, in consequence, looks turbid and 
milky. Sterility is often the outcome. 

In other instances, and these are many, the 
erections gradually become weaker, infrequent, 
the sexual desire vanishes, the emissions are pre- 
cipitated and night losses and losses of seed with 
stool and during urination increase in number. A 
higher and higher degree of impotence develops 
and finally the derided " little dose" has made its 
victim a sexual wreck. 

Effects on Other Parts of the Body. — 
These are so many and varied that only the 
most important can briefly be mentioned. It 
would fill volumes to give a full and accurate 
account of all those symptoms which go to make 
up what is termed "Sexual Neurasthenia" and 
are, in a great many instances, directly or indi- 
rectly caused by the existence of strictures. 

Of such symptoms may be enumerated : 

First, pains in and around the genitals, that 
is, pains in the urethra, the penis, body and head, 
pains around the rectum, in the rectum, the cords, 
the testicles, the groins, etc. They are sometimes 
felt in one place, then in another; again they are 
wandering from place to place; and then again 
are permanently fixed at a certain point, repre- 
senting all varieties as to intensity and location. 

Second, pains radiating farther, that is, pains 
in the legs down to the heels, the back, the bowels, 



BY DR. FERDINAND HERB. 131 

the stomach, bstwsaa the shoulder blades, etc. 

One of these symptoms, namely, the lame back, 
deserves special mention. It is very, very fre- 
quent and, by the laity and also by physicians, 
nearly always blamed to everything else but its 
most frequent cause, the stricture. For many 
years, when a patient presented himself with a 
chronic lame back, we have always looked for, and 
rarely failed to find, the stricture. Then, of 
course, the urethral trouble deserves the main 
attention. Hot and cold applications, massage, 
liniments, internal remedies, etc., may at times 
give temporary relief, but are rarely of lasting 
benefit. The root of the evil must be destroyed 
in order to effect a permanent cure. 

However, though the attention has been called 
to the real cause of the backache, many a patient 
can only be convinced with difficulty that a stric- 
ture lies at the foundation of his ailment. We 
vividly recollect the case of a gentleman, about 55 
years of age, who one day came hobbling into our 
office, supported on the one side by a crutch, on 
the other by a cane. For years he had suffered 
from an occasional backache. Of late, however, 
his condition had become so acute that he could 
move about only with great difficulty and was un- 
able to do manual labor. A stricture was suspect- 
ed and an examination suggested. The very idea 
was received with scorn by the patient who re- 
garded it as an insult. He had, he claimed, never 
had any "disease," nor had he ever noticed any 
abnormality of his urine. The examination being 
flatly refused and the patient bent on having 
something for his "Rheumatism," the demand 



132 GONORRHEA AND SEXUAL DEBILITY 

was under protest granted, but— without benefi- 
cial result. About a week later he returned, ask- 
ing for a change of medicine. This wish was also 
complied with, after a trial with electricity had 
failed to be of benefit. The same negative result 
followed. A week later he again returned in the 
same unimproved condition. Placed now before 
the alternative of submitting to an examination 
for stricture or changing the physician, he yielded 
and a slight but tough stricture was detected near 
the bladder. Strange to say! The mere touch of 
the instrument was followed by improvement. 
What no medicine had accomplished, the instru- 
ment did; the patient experienced immediate re- 
lief. The stricture was stretched a few days 
later. - The scarry tissue tore slightly and a drop 
or two of blood followed the withdrawal of the in- 
strument. The moderate amount of pain, but more 
the sight of blood, frightened the timid patient so 
much that, although he could leave the office after 
this first treatment with a perfect back, he failed 
to return for further treatment. We did not see 
him again until a year or two later when he came 
to consult us about another trouble. Upon in- 
quiry it was ascertained that the backache re- 
mained cured and that he felt perfectly well up to 
the time of this new ailment. And it may be add- 
ed that, to the day of this writing, many years 
later, his backache has never returned, as the pa- 
tient repeatedly assured us. 

But let us add at once that the case was an ex- 
ceptional one in several respects, not only as to the 
swiftness of the cure but also as to the absence of 
urethral symptoms. The patient, it seems, never 



BY DR. FERDINAND HERB. 133 

had had any discharge nor trouble with his urine, 
nor could, or would, he remember an attack of 
gonorrhea. This is a rather rare occurrence, 
granted that he told the truth. In most cases sug- 
gestive symptoms can be found if one knows and 
looks for them. There has been, or there still is, 
occasionally upon rising, particularly after a de- 
bauch, a little moisture at the outlet of the penis 
or a glueing together of the lips of the urethra; or 
there is experienced at times a slight difficulty in 
passing the water; or a little burning, or a dull, 
uncertain, nasty sensation near the rectum may 
be felt. These and other symptoms (see chapter 
on "Chronic Gonorrhea") should put the initiated 
on his guard when a few years after an attack of 
gonorrhea, light or severe, the back begins to 
trouble. 

The intensity of the backache, of course, 
varies greatly. It is usually light and intermit- 
tent in the beginning, days of distress changing 
with weeks or months or, perhaps, years of per- 
fect health. Slowly, however, with the encroach- 
ment upon the urethra the backache increases. 
Finally it reaches a stage where it seems neces- 
sary to ' i do something. ' ' Liniments and plasters 
are first resorted to. Then com® electric belts and 
internal remedies, and finally the doctor is consult- 
ed. Upon his ability to diagnose the case depends 
the sufferer's prospect for relief. 

Besides these local manifestations, there is a 
train of general symptoms, mostly of nervous na- 
ture, ranging from slight nervousness to complete 
nervous breakdown. Any part of the body may 
be affected, but the digestive organs, more than 



134 GONORRHEA AND SEXUAL DEBILITY 

any other, give rise to complaints. Indigestion 
of various kinds; vague, wandering pains or pains 
fixed at certain points of the abdomen, especially 
around the navel; furthermore, headache, general 
weakness, sore spots along the spine, palpitation 
of the heart, sleeplessness, etc., etc.,— may be indi- 
rectly caused by strictures. 

For a better illustration let one of those un^ 
fortunates tell his own story, as he told it to the 
writer. He said in substance: "I have now been 
sick for about nine years with various symptoms 
and half of the time was unable to work. My 
trouble began with pains in the region of the blad- 
der, which slowly crept up in the course of years 
and later radiated over the entire body. Back- 
ache began to torture me, my appetite vanished, 
the bowels became constipated, headache grew 
frequent and restless, dreamy sleep haunted me 
until I am now in a desperate condition, hardly 
able to make a living.' ' 

Questioning revealed the following facts. 
The patient was at that time 28 years of age. At 
18, he contracted a mild gonorrhea, which healed 
in a few weeks. For a year after he felt well. 
Then the trouble began. He employed a physi- 
cian without obtaining relief. He changed doc- 
tors without benefit, going from bad to worse, and 
was treated for various ailments, such as catarrh 
of the bladder, dyspepsia, lumbago, general nerv- 
ousness, nervous breakdown, etc. Being ques- 
tioned whether he had any trouble from his 
former "clap," he said: "No, except that there 
is occasionally a slight burning sensation when 
urinating, and that, at times, the urine does not 



BY DR. FERDINAND HERB. 



135 



come as freely as it used to. ' ' The diminution of 
his sexual appetite, which he began to notice about 
six years before, he attributed to his failing health 
and did not give it further thought. 

This case was typical of those many unfortu- 
nate creatures who spend the few dollars they 
have saved, or can earn, in vain efforts to regain 
their health; who travel from one "Hot Springs' ' 
to another; who try doctor after doctor and finally 
land in the hand of quacks, those merciless vam- 
pires who rob the victim of his last penny and 
then abandon the living corpse to its miserable 
fate. 



ct 



o 



* 



Figure 22. 

bous bougie. 



Bougie. a — olive typed bougie; b — bui- 



lt is, of course, no easy task to restore to 
health such extreme cases as the one referred to. 
Yet, a cure is possible. So it was in our case. 



136 GONORRHEA AND SEXUAL DEBILITY 

Its history gave a good clue as to the cause of the 
misery. Upon examination, a number of stric- 
tures were found. These being properly treated, 
the patient slowly recovered. 

Diagnosis.— Although the symptoms above 
enumerated are very suggestive and should 
at once direct one's attention to the possibility of 
a stricture, there is only one way to find out defi- 
nitely, and that is, by an examination with a bou- 
gie. This latter is a long, pencil-like instrument 
of soft, flexible texture (see Figure 22). It is far 
better for diagnostic purposes than the steel 
sound, still frequently used by physicians. Steel 
sounds override slight strictures, fai] to indicate 
soft strictures altogether, and do not afford the 
fine, sensitive touch so essential to a proper diag- 
nosis. They are, therefore, in our opinion, utterly 
useless for difficult cases, although tough and 
tight strictures can be detected with them. A 
great many times, using these bougies, we have 
found strictures where others denied their exist- 
ence and our blunt steel dilator also slipped in 
without a hitch. 

It is absolutely essential not to overlook the 
slightest stricture in order to do justice to the 
case. It is by no means always the tight stricture 
which causes the most trouble. We have treated 
scores of patients who exhibited the most intense 
nervous symptoms, though the bougie revealed but 
slight encroachment, while the steel sound gave no 
clue whatever. 

An instrument of medium size is best for ordi- 
nary purposes. 

The passing of an instrument through the 



BY DR. FERDINAND HERB. 137 

urethra into the bladder is a performance which 
may result in great harm by the introduction of 
dangerous microbes, if done carelessly. To avoid 
«vil consequences, a thorough disinfection of the 
instrument is the first and most indispensable pre- 
requisite. It is accomplished as follows: Pre- 
pare a solution of Ehenolin (Prescription 36), 
two teaspoonfuls to a pint of freshly boiled water. 
Place bougie in this solution and allow it to re- 
main there for about one-half hour. Then take it 
out, rinse off with freshly boiled water to remove 
the disinfectant, dip point into glycerin and intro- 
duce into urethra after the penis has been pre- 
pared in the same manner as before the introduc- 
tion of a steel sound (see later). 

Prescription 36. 

Rhenolin 4 ounces 

Two teaspoonfuls to a quart of water. 

If there is no stricture, the instrument glides 
in smoothly without stopping except at the end of 
the urethra where a slight resistance is encoun- 
tered while overcoming the cut-off muscle of the 
bladder. On passing, no real pain is felt if the 
<?anal is normal. Sore places, as, for instance, fre- 
quently exist behind strictures, are indicated by a 
sharp, cutting sensation as soon as they are 
touched. Slight or soft strictures arrest the in- 
strument but for an instant, while tied and hard 
ones stop it entirely. The passing of the stricture 
is marked by a jerk, more or less pronounced. If 
doubt exists, the repeated shifting of the instru- 
ment back and forth will remove it, as the same 
jerk will be distinctly felt each time while passing 
the obstruction. 



138 GONORRHEA AND SEXUAL DEBILITY 

These phenomena are so distinct and charac- 
teristic that no one should fail to arrive at the 
proper conclusion. There is but one pitfall. In 
sensitive persons, the muscles around the deepest 
part of the urethra may suddenly contract in a 
cramplike manner when the point of the instru- 
ment comes closer to the bladder. Thus it is 
caught in a similar way as it would be by a stric- 
ture, if one existed. For definite determination, 
one should hold the instrument against the ob- 
struction for a short while under gentle pressure. 
If it is merely a cramp, the muscles will soon relax 
and leave the urethra unobstructed, and the sound 
may then be gently shifted back and forth without 
hindrance. 

Treatment.— The treatment of strictures 
should, if possible, be placed in the hands of a 
competent physician. We say " competent' ' ad- 
visedly and with great emphasis, as by no means 
every physician deserves this designation. A 
good many of them are no more, yes, even less, fit 
to handle the sound than the well instructed 
patient. 

We, therefore, will describe the treatment 
fully. The details may serve as a guide for either 
self -treatment or the passing of an intelligent 
judgment on the treatment at the hands of a phy- 
sician. 

The treatment of strictures must be instru- 
mental in by far the majority of cases. Only few 
are amenable to medicines, namely, those where 
the obstruction is caused by no scar (see above). 
However, as under such circumstances the use of 
the sound is also of great benefit, the patient need 



BY DR. FERDINAND HERB. 139 

not concern himself about the difference. 

Before we enter upon this subject more 
minutely, it becomes desirable to dispel a notion 
which has been built up in the mind of the laity by 
the advertisements of quacks and fakirs. This is 
the erroneous belief that strictures can be dissolved 
with remedies, either applied locally or taken in- 
ternally. Thoughtful reflection upon what has 
been said in previous pages as to the nature and 
character of strictures must make it evident that 
this cannot be done, except where they are formed 
by infiltrations. Scars in the urethra cannot dif- 
fer materially from scars on the external parts of 
the body. Everybody knows that these latter 
cannot be dissolved. They can be cut and 
stretched, they may become pale and less visible, 
but they cannot be dissolved. 

So with strictures formed by scar- tissue. 
They can be cut and stretched and rendered harm- 
less, but they cannot be dissolved by medicines in 
the manner ordinarily claimed. 

There is, however, one exception to this rule. 
It has been discovered lately that Thiosinamine 
possesses the remarkable property of bringing 
scar-tissue to absorption wherever located. But 
it must be given hypodermically to be of benefit. 
It is absolutely ineffective if it is applied locally 
or taken internally. 

Though Thiosinamine has given splendid re- 
sults in some of our cases, details as to its use must 
be omitted as sufficient experience has not yet 
been gathered to warrant its employment by the 
laity. It must suffice to have attention drawn 
to it. 



140 GONORRHEA AND SEXUAL DEBILITY 

Treatment with Sounds. — The sound is an 
instrument made of silver or nickeled steel. Its 
shape is given in Figure 23. 

Sounds are numbered according to their size. 
Several scales are used. The French scale is the 
most popular. Number 20 French (about 13 to 14 
American) is about the caliber suitable for the 
first insertion. It may, however, prove to be too 
small for some, too large for other cases. It all 
depends on the size of the stricture and that of the 



r 



m 



Figure 23. — Sound. 

outlet of the urethra. The sound should be so 
large that it just passes the narrowed place and its 
size should be increased as the passage widens. 
This necessitates a set of instruments. 

Preparation of the Instrument. — Clean 
sound thoroughly with soap and hot water and, 
then, boil it for fifteen minutes. Never attempt to 
introduce it without this thorough disinfection. 

A steel sound may also be sterilized by repeat- 
edly dipping it into alcohol and burning it off. 

Preparation of the Patient. — Clean hands 
thoroughly with plenty of soap and hot water and, 

Prescription 37. 

Rhenolin 4 ounces 

Two teaspoonfuls to a quart of water. 

then, with a solution of Ehenolin (Prescription 
37), two teaspoonfuls to the pint of boiled water. 
Retract foreskin and wash head of penis with soap 



BY DR. FERDINAND HERB. 1 4 1 

and hot water. Finally urinate to clean out 
urethra. To neglect this precaution may cause 
serious consequences. 

Technic of Introduction. — These preparations 
made, lie down on bed or couch, strip foreskin 
back, take head of penis between thumb on the one 
side and second and third finger on the other, dip 
tip or beak of instrument in glycerin, open lips of 
urethra with fingers holding penis, and introduce 
sound in such a way that, in the beginning, it is 
held over the groin, across the body (Figure 24). 




Figure 24. Sound over groin. a b — sound. 

the handle nearly touching the skin. As soon as 
the curve has disappeared in the urethra, swing 
the instrument slowly until it lies over the middle 
line of the abdomen (Figure 25), the handle still 
close to the skin. The latter is now slowly raised 
and pushed with a gentle pressure in the direction 
of the canal. Arriving at a horizontal position, or 
just after, the pressure should cease, as the sound 



142 GONORRHEA AND SEXUAL DEBILITY 

will be carried the rest of the way by its own 
weight. 

The entrance of the beak into the bladder is 
manifested by a sinking down of the handle be- 
tween the legs. If the beak be caught and held 
back in front of the bladder, the handle does not 
sink down but has a tendency to rebound, while 
the skin in front of the rectum bulges out. 

If this happens, withdraw sound a little, lay 



A 



Figure 25. — Sound over abdomen. a b — sound. 

fingers of free hand at the bulging point, press 
beak up towards the front wall of the urethra 
and re-introduce. Eepeat the procedure, if neces- 
sary, or turn beak a little to the right or left by 
way of search. According to the location of the 
stricture, it may at times uerve the purpose best 
to press the beak down in order to bring it over 
the obstruction. 

The entire procedure must be done gently, 



BY DR. FERDINAND HERB. 143 

very gently. Strong pressure should be absolute- 
ly avoided. It is multiplied many times at the 
beak and may force this end into the inflamed tis- 
sue, forming a so-called " False Passage." This 
is an unfortunate occurrence, as it creates a most 
serious complication. 

The introduction of a sound into a healthy 
urethra is accompanied by a sensation as of prick- 
ing points and followed by a desire to urinate as 
soon as the bladder is approached. If the muc- 
ous membrane is diseased, these sensations are, 
of course, intensified. In extreme cases, nausea, 
even fainting spells, may be occasioned by the first 
introduction. 

Complications Caused by Sounding. — Besides 
the fainting spells, just mentioned, there are sev- 
eral complications which may be occasioned by 
sounding. These are: 

False Passage. — Unskilled manipulations or 
too great pressure may push the beak of the in- 
strument into the inflamed tissue and create a 
pocket, a so-called " False Passage." Such 
pockets are not only dangerous as hiding places 
for microbes and starting points for abscesses, but 
are also a constant source of annoyance during 
future soundings, as the back of the instrument is 
frequently caught again in these very pockets. 

Gentleness during sounding will prevent the 
occurrence. 

Urethral Fever. — Fever following the pas- 
sage of a sound is called ' ' Urethral Fever. ' ' It is 
caused by the infection of the blood with microbes 
from the urethra. A chill ushers it in ; then follow 
aching pains all over the body with urinary dis- 



GONORRHEA AND SEXUAL DEBILITY 



turbances, such as burning in the urethra, fre- 
quent urination, etc. The symptoms usually sub- 
side in a few days. 
Urethral Fever can be prevented: 

First, by paying strict attention to the disin- 
fection of hands, instruments, penis, etc. 

Second, by care and gentleness in passing the 
sound. Any bruise or tear, resulting from too 
great force or carelessness, may serve as the open 
door for the everywhere lurking microbes. 

Third, by taking remedies which render the 
urine antiseptic (see later). 

Inflammation of the Testicle. — This compli- 
cation may follow in spite of the utmost care. 
Should it occur, further instrumental treatment 
must be postponed until the acute pain and swell- 
ing have disappeared. 

Wearing a suspensory and taking the same 
precautions as against urethral chills, also tend to 
prevent the inflammation of the testicle. 

Size of Sound. — Most strictures, when first 
detected, are still of such caliber as to admit the 
introduction of a good sized steel sound. It is, 
therefore, best to try first No. 20, French scale (13- 
to 14 American). If it enters the bladder, it 
should remain for a few minutes and then be with- 
drawn. If it does not, and cannot be made to do 
so in spite of gentle persistence, it is better to ab- 
stain from further efforts on that day, as they in- 
volve some risk. As soon as the irritation caused 
by this first attempt has subsided, that is, after 
one to three days, try a sound three or four num- 
bers smaller. 

If No. 20 passes, a larger size should be used 



BY DR. FERDINAND HERB. 145 

the next time, and so on gradually until about No. 
30 to 33 has been reached. The narrowness of the 
entrance to the urethral canal usually forbids the 
passage of still larger sounds. If, however, 
larger instruments can be passed without violence, 
it is advisable to do so. The greater the dilation, 
the safer will the patient be against the recurrence 
of the stricture. 

Repetition of the Treatment. — Every treat- 
ment is followed by a more or less marked reac- 
tion, indicated principally by discomfort and pain 
during urination. Not until these have passed 
away entirely, should the next attempt be made. 
It matters not if four or five or six or still more 
days intervene. Too great eagerness and hurry 
bring detriment instead of benefit. Persistency 
is laudable, but patience still more so. 

Urinary Antiseptics. — An antiseptic urine is 
not only a safeguard against urethral chills and 
fever, but also hastens the subsidence of the dis- 
tressing symptoms of reaction. It is, therefore, 
advisable in all cases where sounds are passed to 
take either Hexamethylenamine (Prescription 38) 
or, better, Methylene Blue Tablets (Prescription 
39), as long as the instrumental treatment is con- 
tinued. No one can afford to neglect this precau- 
tion. If the operations are made at greater inter- 
vals, it will sometimes suffice to take the remedy 
one day before and from two to four days after 
the treatment, according to the amount of dis- 
charge and pus in the urine. 

Prescription 38. 

Hexamethylenamine .. 4 grain tablets, No. 50 
One tablet dissolved in water three times 
a day. 



146 GONORRHEA AND SEXUAL DEBILITY 

Prescription 39. 

Methylene Blue, 

Nutmeg, each 2 grains 

Made Into tablet, pill or capsule. One 
three times a day. 

Alkalies and Balsamics. — They must be used 
to mitigate • the pain after treatment in extreme 
cases. For further particulars see Chapters 14 
and 20. 

Strictures of Very Small Caliber. — These are 
very difficult to treat and require such a variety 
of instruments, so much skill and special knowl- 
edge that self -treatment is impossible. 

Where Sounds Should Not be Used. — It is 
not advisable to proceed with instruments in every 
case of stricture. If there exists a thick, creamy, 
or a great quantity of slimy discharge, or if the 
urethra is very much inflamed and tender, — the 
passage of the sound should not be attempted. 
The operation is dangerous under such circum- 
stances, as urethral chills, blood poison, inflam- 
mation of the bladder and testicles, etc., frequent- 
ly follow. This rule excludes from treatment 
with sounds all cases of new infection, or old cases 
in which a new infection has supervened. 

Cases coming under this latter category 
should first be treated according to the rules laid 
down in the chapters on " Acute and Chronic 
Gonorrhea/ ' until conditions have improved suf- 
ficiently for instrumental treatment. 

Combination Treatment. — Treatment with 
sounds or dilators very frequently effect a speedy 
cure of the existing discharge. If it does not, it is 
best to apply simultaneously the treatment out- 
lined for chronic gonorrhea. Silver injections 



BY DR. FERDINAND HERB. 147 

should first be used and astringents later. Bal- 
samic remedies had better be avoided until the 
stricture is well dilated. We have noticed in a 
number of instances that these internal remedies 
toughened and hardened strictures to such an ex- 
tent that they became very difficult to treat. 
The reader may profit by this experience. 

Injections become more effective, the more 
the stricture is dilated, as they have a better 
chance to reach the seat of the trouble. It thus 
often happens that after the removal of the ob- 
struction local applications accomplish quickly 
what they could not do before. 

After Treatment. — If the stricture has been 
well dilated, the discharge stopped, and the pus 
and shreds made to disappear from the urine, it 
by no means follows that the treatment can be 
discontinued. The cure must be maintained or 
the stricture will return. To this end it is neces- 
sary to continue the passage of the sound occa- 
sionally, that is, first once a week, later every sec- 
ond week, then once a month and so on to once a 
year, as circumstances may demand. The patient 
must study his own case and use his best judgment. 
It may be unpleasant to again and again return to 
the sound, but the cure is not lasting unless this 
be done. 

TREATMENT WITH DILATORS. 

Steel sounds, though very convenient for self- 
treatment, have a great many drawbacks. A 
whole set is required to meet the changing condi- 
tions of the case; larger numbers, which may, per- 



148 GONORRHEA AND SEXUAL DEBILITY 

haps, be necessary for the proper treatment of the 
stricture, can often not be introduced on account 




Figure 26. — Dilators. a and b stretch to four sides 
and are far superior to c, which stretches only to two sides. 



BY DR. FERDINAND HERB. 149 

of the narrowness of the entrance to the canal; 
and the stretching under such conditions must, 
therefore, of necessity be quite insufficient. 

These disadvantages are overcome by using so- 
called "Dilators," that is, instruments which can 
be widened while lying in the urethra. A great 
many different models are on the market, of which 
Kollman's is the best (Figue 26), as it opens and 
stretches equally to four sides. It is a superior 
instrument and has given the greatest satisfaction 
in our hands. 

The following are the advantages of the di- 
lator: 

First, one instrument is sufficient for all 
cases. 

Second, a narrow mouth of the urethra is no 
hindrance. 

Third, the treatment is far more gentle than 
with sounds. 

Fourth, no case is beyond its reach. With it 
dilation can be carried to the highest possible 
point. This fact is of the utmost importance, as 
a very extended experience has convinced us that 
many a backache, pain in the leg, urinary trouble, 
etc., cannot be entirely cured until the dilation has 
reached the highest mark. 

But though Kollman's Dilator is in compari- 
son to the steel sound what the railroad is to the 
stage coach, it serves no purpose to give details of 
treatment. The price makes the instrument pro- 
hibitive, and the treatment is so beset with diffi- 
culties that no one but the expert can apply it 
properly. 



150 GONORRHEA AND SEXUAL DEBILITY 

CUTTING OF STRICTURES. 

We need not dwell on the cutting of the stric- 
tures at great length, as it requires the employ- 
ment of an expert. Besides, we must admit that 
we were never in favor of this operation, except in 
most exceptional cases. It is true that the cutting 
of the scar opens the canal quickly, but it is also 
true that this fresh wound will heal again and the 
new scar reduce the size of the urethra to the same 
dimensions as before, unless the same persistent 
treatment with sounds follows which has been out- 
lined above. 

To cut soft and pliable strictures, as some phy- 
sicians do, does more harm than good and should 
be severely condemned. Dilators, as Kollman's, 
are strongly built instruments and can handle 
nearly all, even very tough, strictures. The bet- 
ter one becomes acquainted with their work, the 
less need is found for cutting, to the great and 
lasting benefit of strictured men. 



BY DR. FERDINAND HERB. 



151 



CHAPTER XXV. 



INFLAMMATION OF THE PROSTATE GLAND. 

The Prostate Gland is a hard, solid body of 
the size and shape of a chestnut, lying around the 
urethra near the bladder (Figure 27). Through 
numerous ducts its secretion flows into the 
urethra. By way of these very ducts the gono- 
cocci, in many instances, enter the gland and, ac- 
cording to circumstances, cause either an acute or 
chronic inflammation. 




Figure 27. Prostate gland (c) located near the blad- 
der around the urethra. 



152 GONORRHEA AND SEXUAL DEBILITY 

ACUTE INFLAMMATION OF THE PROSTATE 
GLAND. 

This is a rather rare disease, often terminat- 
ing in an abscess. The symptoms, such as chill, 
fever, bulging and severe pains in front of the 
rectum, difficulty in, or impossibility of, urination, 
etc., are so violent and distressing that a physi- 
cian will and should always be summoned. Men- 
tion of it is made only to draw attention to the 
possibility. 

CHRONIC INFLAMMATION OF THE PROSTATE 
GLAND. 

This form is far more frequent, yes, a rather 
common accompaniment of chronic gonorrhea. 
The symptoms very much resemble those of the 
latter ailment. They consist in the oozing of a 
thickish, turbid, slimy or slimy-mattery secretion, 
sometimes tinged with blood. Larger quantities 
appear in the urine and at the mouth of the 
urethra after a hard movement of .the bowels. 

This discharge is accompanied by a vague 
sensation of heaviness near the rectum, pains run- 
ning from the rectum towards the penis, the back 
and the legs and along the urethra, painful emis- 
sions, frequent and difficult urination, etc. 

To find out definitely if the prostate gland is 
affected proceed thus: Clean urethra of all dis- 
charge by urinating, introduce finger well greased 
with Petrolatum into the rectum and massage 
gland for a short while. Thereby its contents are 
pressed into the urethra and can be squeezed out 
from there by milking along the lower side of the 
penis. 



BY DR. FERDINAND HERB. 153 

Treatment.— The treatment must always be- 
gin by first removing the chronic gonorrhea and 
strictures, which usually accompany the chronic 
inflammation of the prostate gland (see Chapters 
22 and 24). 

A light, easily digestible diet, with less meats 
and more vegetables and fruit, tends to bring 
about a good daily movement of the bowels and 
hastens the cure. Constipation irritates and 
makes conditions worse. Plenty of water, milk 
and other non-irritating drinks are advisable. 
Too much exercise, excesses, physical and mental, 
all sexual irritation and also heavy alcoholic 
stimulants, must be avoided. 

Hot irrigations of the urethra and the rectum, 
as described in Chapter 13, are the best local 
applications. 

Next come remedies applied into the rectum, 
Ichthyol and Soluble Silver Ointment (Prescrip- 
tions 40 and 41). 

Prescription 40. 

Ichthyol % drachm 

Hydrous Wool Fat, 

Petrolatum, each enough to make 2 ounces 
Apply ahout one drachm. 

Prescription 41. 

Rheno Silver Ointment ~. . 1 ounce 

Apply one-half drachm. 




Figure 28. Pile Pipe. 

Either ointment is best applied by means of a 
"Pile Pipe" (Figue 28). Or the remedies may be 
made into suppositories. 



154 GONORRHEA AND SEXUAL DEBILITY 

Of internal remedies only one gives any prom- 
ise, namely, Fluid Extract of Ergot (Prescription 
42). 

Prescription 42. 

Fluidextract of Ergot 3 ounces 

Twenty to forty drops three times a day 
between meals. 




BY DR. FERDINAND HERB. 155 



CHAPTER XXVI. 



INFLAMMATION OF THE TESTICLES. 

The seminal ducts, the conduits for the semen, 
run from the testicles up in front of the bone above 
the penis, enter the abdominal cavity at the same 
place where the ruptures come out, pass first aside, 
then behind the bladder, and finally perforate the 
prostate gland and empty into the urethra 
(Figure 29). 

This is the very road, though in the opposite 
direction, on which the gonococcus travels to 
reach the testicle. 

Causes.— The causes leading to the inflamma- 
tion of the testicle are manifold : Inflammation of 
the prostate gland, strictures, careless manipula- 
tions with instruments in the urethra, pulling and 
tugging on the spermatic cords by low hanging 
testicles, violent exercise, bicycling, horse back 
riding, jumping, lifting heavy loads, sexual 
excitement, etc., etc. 

It is true that too strong injections may also 
give rise to the disease; it is, however, not true 
that all and every gonorrheal inflammation of the 
testicle is the result of local applications, as some 
fakirs and unscrupulous vendors of remedies for 



156 



GONORRHEA AND SEXUAL DEBILITY 



internal use would like to make a credulous public 
believe. As proof we point to those innumerable 
cases which develop the above named complica- 
tion without ever having used a syringe. 

One-Sided or Double Inflammation.— Inflam- 
mation of the testicle usually develops but on one 
side. If both testicles become involved, the in- 




Figure 29. Course of the spermatic cord. a — blad- 
der; b — wall of the bladder; c — prostate gland; e — seminal 
vesicle; f — spermatic cord; g — pube bone, that is, the bone 
above the penis; h — rectum; i — end of the back bone; k — 
urethra; m — testicle; n — -epididymis, usually the seat of 
the inflammation if gonorrhea attacks the testicle. 

The semen is produced in the testicles, passes along 
the spermatic cords, is stored in the seminal vesicles, is 
discharged from there during coition into the urethra and 
thus reaches the outside. 

flammation on the one side generally precedes that 
on the other by several days or weeks. 

Prevention.— Although the inflammation of 
the testicle cannot, with certainty, always be fore- 
stalled, a great deal can be done towards its pre- 
vention. Above all, the testicles should be rested 



BY DR. FERDINAND HERB. 157 

comfortably in a tightly fitting suspensory in 
every case of gonorrhea, acute or chronic, severe 
or light, so that all strain on the spermatic cords 
is avoided. But in order to be of real benefit, the 
suspensory must actually lift the testicles against 
the body, for a suspensory in which the testicles 
hang too low will do no good. We have always 
experienced great difficulty in impressing this im- 
portant point upon our patients. Under such cir- 
cumstances the suspensory must be padded with 
absorbent cotton until the testicles rest so high 
that they cannot be lifted any higher even by 
hand. 

Furthermore, all those causes above enumer- 
ated must be avoided. 

A mild silver injection in the beginning of the 
disease is another splendid preventive. It is evi- 
dent that the killing of the specific germ will aid 
greatly in precluding this as well as other unpleas- 
ant complications. 

Symptoms.— Dull or darting pains in the 
region of the groins, running in the direction of 
the spermatic cord down to the testicle, usually 
mark the beginning of the complication. They 
are more pronounced while standing or walking, 
less while sitting or lying down, and are usually 
entirely relieved by lifting the diseased testicle 
with the hand tightly against the body. 

A few days later the inflammation sets in. 
The testicle swells and becomes painful. The 
skin reddens and feels hot. Very frequently there 
is fever in the beginning and sometimes a chill. 

As the swelling increases, the pain grows 
worse. Walking gradually becomes more difficult 



158 GONORRHEA AND SEXUAL DEBILITY 

and sometimes impossible; sleep is restless and 
disturbed. 

The size of the testicle varies from a hardly 
noticeable enlargement to the circumference of a 
large fist. 

Very peculiar is the effect on the urethral dis- 
charge. It decreases considerably, or ceases en- 
tirely, as the swelling progresses, but increases 
again as it subsides. 

Course and Consequences.— The length of 
the attack varies greatly in different instances and 
depends largely on the care and management of 
the case. While the pains yield readily to proper 
treatment, the swelling does not. It takes weeks 
or months until it is gone, yes, in some cases, there 
remains a slight chronic enlargement for years. 

Besides pain and distress, there is something 
more at stake than physical discomforts, namely: 
The procreative power. The inflammatory exu- 
dation in many instances permanently obstructs 
the outlet of the seminal duct, and, although the 
testicle remains seemingly unaltered, the seminal 
fluid is deprived of its fertilizing elements. If 
both sides become affected, the unfortunate ' i little 
dose" may render its victim hopelessly sterile, un- 
able to beget offspring and forever deprived of 
that real joy of family life which the presence of 
children alone can offer. 

Treatment.— The treatment must begin by 
resting the diseased testicle. Whether this is best 
done by lying in bed or by applying a suspensory 
depends upon the circumstances of the individual 
case. If it be severe, the patient should go to bed. 
Lying in a horizontal position with the testicles 



BY DR. FERDINAND HERB. 159 

elevated to the highest possible point affords the 
best chance for relief and improvement. The ele- 
vation is secured either by resting the swollen 
organ upon a soft cushion placed between the legs 
or, better, especially if the patient is restless, by 
applying a bandage in the following way: 

Wind towel around waist. Fold napkin, or 
any other cloth sufficiently large, into triangular 
shape (Figure 30). Place middle of base (Fig- 
ure 30a) behind testicle and attach angles (Figure 
30 bb and c) to waist band. If the cloth has a ten- 
dency to slip, connect base by a tape with the 
waist band in the middle of the back. 




Figure 30. Triangular shaped cloth. a — middle of 
base to be placed behind the pouch of the testicles; b b c 
«nds to be fastened to the waist band. 

Cold or hot applications are next to elevation 
in efficiency. Which one is preferable depends 
upon a trial We usually try ice first in severe 
cases, as it relieves more quickly, and change to 
heat where cold is rejected. 

How to apply ice: Fill small ice bag with 
finely crushed ice. Spread over testicle, properly 



160 GONORRHEA AND SEXUAL DEBILITY 

elevated, a piece of moist linen. Place the icebag 
npon this and hold it in place with a bandage. 
Never apply the bare rubber directly to the skin. 
If the ice is too cold, place two or three more 
layers of moistened linen under it. The linen 
must be damp as the cold does not penetrate suf- 
ficiently through dry cloth. 

The effect, in cases suitable for ice, is nearly 
always soon apparent. The pain ceases, the pro- 
gress of the inflammation stops, and the patient 
is comforted. If relief does not follow, replace 
icebag by linseed poultices, applied as hot as can 
be borne, and change whenever they begin to cool. 

Even in those cases favorable to ice a change 
to heat is advisable as soon as the infla mm ation 
is checked, that is, after two to four days. The 
moment to change has arrived when the testicle 
becomes painless to pressure. Should pain 
return upon the application of poultices, the ice 
may be re-applied for a short time. 

As soon as the patient is well on the road 
to recovery, he may rise. In such case, or when 
he is not able to go to bed, the application of a 
tightly fitting suspensory is indispensable. A 
size sufficiently large to allow a good padding 
with absorbent cotton is always best. This prop- 
erly applied relieves the pain immediately and 
makes walking easy. If it does not, it is a sure 
sign that the fitting is bad. To make a test, take 
the testicle in the palm of the hand and press it 
gently upward against the body. If this relieves 
better than the suspensory, the latter can, and 
should be, improved upon, until it equals in effect 
the lifting up with the hand. 



BY DR. FERDINAND HERB. 161 

Remedies. — Many have been recommended, 
but few are effective. 

After trying most of them, we have, of late, 
given preference to the ointment in Prescription 
43 and rarely failed to see the most satisfactory 
results. Applied once or twice a day, morning 
and evening, it quickly stops the pain, reduces 
the swelling and brings about a cure in the short- 
est possible time. 

Prescription 43. 

Ichthyol, 

Oil of Gaultheria, each 3 drachms 

Hydrous Wool Fat, 

Petrolatum, each enough to make. .2 ounces 

Proceed thus: Apply ointment thickly; cover 
the entire pouch of the testicles with a layer of 
thin linen and, then, a piece of soft, pliable oiled 
silk, the latter in order to prevent the remedy 
from soaking into the bandage. Finally, slip on 
the suspensory, prepared in the manner described 
above. 

The use of the ointment is usually painless. 
Should it, however, begin to smart after a num- 
ber of applications, it is best to stand the pain, 
provided it is not too severe. If necessary, an 
addition of some Hydrous Wool Fat or Petrola- 
tum will reduce the strength of the ointment and 
also the pain. 

Another remedy is Ichthyol (Prescription 
44), a thick, tar-like fluid. It is applied as direct- 
ed with a camel 's hair brush, covered with a 
layer of cotton as thin as possible, and allowed 
to dry. Then, the suspensory is placed in position. 

Prescription 44. 

Ichthyol 1 ounce 

Apply every two to three days. 



162 GONORRHEA AND SEXUAL DEBILITY 

Guaiacol (Prescription 45) is also frequently 
used with good success. It is a white fluid of 
sharp, acrid smell and taste, similar to creosote. 
An application with the undiluted remedy, ap- 
plied with a camel's hair brush, sometimes cuts 
the inflammation short; but it is a very painful 
medicine and, therefore, cannot be put on more 
than once or twice. 

Prescription 45. 
Guaiacol 1-3 ounce 

Weaker solutions (Prescription 46) burn less, 
but are also less effective. They are, however, of 
great service in some cases. 

Prescription 46. 

Guaiacol 1-3 ounce 

Alcohol % (to 1) ounce 

Injections must be stopped immediately ab 
soon as an inflammation of the testicle begins and 
should not be resumed until it has practically 
subsided. They must then be resumed very cau- 
tiously, with greatly reduced strength, say one- 
half to one-third of the usual concentration, and 
one-half or one-third of the usual quantity. 
Gradually the strength may be raised and the 
quantity increased as it is seen that no evil con- 
sequences follow. 

Constipation, usually accompanying the in- 
flammation of the testicle, has a bad influence upon 
the disease and should receive proper attention. 

To prevent the recurrence of the trouble, a 
suspensory should be worn for a long time after. 



BY DR. FERDINAND HERB. 163 



CHAPTEE XXVII. 



INFLAMMATION OF THE BLADDER. 

The bladder is also frequently infected by the 
gonococcus. It matters not whether the gonor- 
rhea is acute or chronic, severe or slight, — the 
complicating cystitis, that is, inflammation of the 
bladder, may arise at any time. Sometimes the 
cause is plain, such as passing of a sound, forcing 
of urethral injections into the bladder, catching 
cold, etc. ; sometimes it is obscure, especially if the 
bladder becomes involved again and again at the 
slightest provocation. In such instances we must 
assume that the patient is predisposed to the 
trouble, that is, catches it easily, while others may 
remain free in spite of the grossest negligence. 

Prevention.— The continuation of the gonor- 
rheal inflammation of the urethra to the mucous 
membrane of the bladder can, and should be, pre- 
vented under ordinary circumstances. 

To this end it is advisable during an attack 
of gonorrhea to continually take some urinary an- 
tiseptic, such as Hexamethylenamine (Prescrip- 
tion 47), or, better, Methylene Blue (Prescription 
48). They not only keep the infection from the 
bladder, but also have a beneficial influence upon 



164 GONORRHEA AND SEXUAL DEBILITY 

the urethral disease. The partaking of large 
drafts of water, lemonade, milk, buttermilk, soft 
drinks, etc., also helps materially through the re- 
sulting washing out of the bladder. If instru- 
ments are used, all precautions mentioned in pre- 
vious chapters should strictly be observed. The 
same is true of the abstention from alcoholic 
stimulants, violent exercise, sexual irritation, etc. 
The best, however, and most effective preventive 
is the eradication of the gonococcus with a mild 
silver injection at the early stage of the disease. 

Prescription 47. 

Hexamethylenamine . . 4 grain tablets, No. 50 
One tablet dissolved in water three times 
a day. 

Prescription 48. 

Methylene Blue, 

Nutmeg, each 2 grains 

Make into tablet, pill or capsule. One 
three times a day. 

Symptoms.— Dull or cutting pains in the re- 
gion of the bladder combined with frequent and 
painful urination point unmistakably to the seat 
of the trouble. An inspection of the urine con- 
firms the diagnosis. In the beginning it is but 
slightly altered. Soon, however, the change be- 
comes apparent. It looks turbid, muddy, or of 
whitish color if only matter, of white-red color if 
both matter and blood are present. Upon stand- 
ing, a thick, tenaceous, coherent sediment is 
formed, consisting of matter and slime. 

However, a mistaken conclusion is possible 
unless the examination is made in the proper way. 
As a gonorrheal cystitis is nearly always accom- 



BY DR. FERDINAND HERB. 165 

panied by a urethral and prostatic inflammation 
of the same origin, the urethra generally contains 
discharge coming from these two latter places. 
This may cause error. To avoid it proceed thus : 

Take two glasses ; pass first portion of urine 
into the one, a second portion, without stopping, 
into the other glass. As all matter originating 
from the urethra and the prostate gland is cleared 
out with the first urine, the conclusion to be drawn 
as to the condition of the bladder depends upon 
the appearance of the second portion. If it is 
clean and transparent, the bladder is not affected ; 
if it contains pus, cystitis exists. 

This test verifies the diagnosis and should 
always be made where doubt exists. 

Treatment.— Strictures and inflammation of 
the prostate gland, if in existence, must be treated 
according to the rules given in previous chapters. 
To neglect them means to delay the cure and in- 
vite relapses. 

Cystitis demands, first of all, proper diet and 
rest. 

Plenty of warm water, lemonade, milk, pep- 
permint tea, etc., should be taken, but no bever- 
ages containing alcohol, such as beer, wine, 
brandy, whisky, gin, etc. Of special benefit is tea 
made of the leaves of the Bearberry (Prescrip- 
tion 49). 

Prescription 49. 

Uva Ursi 3 ounces 

A pinch to a cup of tea. 

The food should be light: Oatmeal, rice, 
breakfast foods, soft and poached eggs, fresh 
green vegetables, cooked fruit, etc. Highly salted 



166 GONORRHEA AND SEXUAL DEBILITY 



and spiced dishes are forbidden. 

The bowels mnst move freely, as constipation 
brings increased pain. Injections with warm salt 
water, that is, one teaspoonful of table salt to a 
quart of boiled water, serve the purpose best. If 
they do not take effect, nse soap water. Castor 
Oil will also do. 

Best in bed is required only for acute cases, 
but as little exercise as possible for all of them. 
Long walks, dancing, fencing, outside sports re- 
quiring quick movements, horse back riding, bi- 
cycling, jumping, etc., are forbidden. If the dis- 
tress be great, hot linseed poultices or, better, hot 
hip baths (Chapter 13) are excellent and relieve 
it almost instantaneously. The pain disappears, 
the urine flows easily and freely, the intense de- 
sire to pass water lessens, and a restful sleep 
refreshes the worn out body. 

Medicines. — They are either taken internally 
or applied locally. Of internal remedies we have 
again to mention Hexame thylenam i n e (Prescrip- 
tion 50) or Methylene Blue (Prescription 51). 
Either will answer the purpose, but the latter is 
usually best. 

Prescription 50. 

Hexamethylenamine . . 4 grain tablets, No. 50 
One tablet dissolved in water three times 
a day. 

Prescription 51. 

Methylene Blue, 

Nutmeg, each 2 grains 

Make into tablet, pill or capsule. One 
three times a day. 

To remove more quickly the distressing symp- 
toms of the acute stage, Salicylate of Sodium 



BY DR. FERDINAND HERB. 167 

(Prescription 52) or Salol (Prescription 53) have 
proved valuable additions to the above mentioned 
urinary antiseptics and can advantageously be 
taken together with the latter until the most seri- 
ous stage is passed. They rarely disappoint ex- 
pectations, but do not always agree with the 
patient's stomach. 

Prescription 52. 

Sodium Salicylate 1 ounce 

Water, enough to make 4 ounces 

One teaspoonful three times a day after 
meals. 

Prescription 53. 

Phenyl Salicylate .. 1 6 grain powders, No. 25 
One powder three times a day after meals. 

Should they fail to give prompt relief, the 
balsamic remedies, mentioned in Chapter 20, may 
be tried. They also do well under such circum- 
stances. 

Still another remedy is Haarlem Oil, a rather 
old and familiar friend of the public. It gives 
very satisfactory results in acute as well as in 
chronic cases. Moreover, it possesses not only a 
great soothing and healing influence upon the 
mucous membrane of the urinary canal, but, in 
contrast with the other oils, also acts very favor- 
ably upon digestion. The remedy can be bought 
at any drugstore ; ten to twenty drops constitute a 
dose. 

All local treatment had better be omitted so 
long as the disease is at its height, except in such 
instances where instruments must be used to with- 
draw the urine. 

In later stages, local applications are very 
beneficial and cannot be dispensed with. They 



168 GONORRHEA AND SEXUAL DEBILITY 

consist in washing out the bladder. This can be 
done either by forcing the cut-off muscle, as 
described in Chapter 19, or by introducing the 
catheter so far that its eye lies in the bladder. 
Everything else, especially the precautions, mode 
of introduction, etc., are the same as given in 
Chapter 13. 

Solutions to be used: 

Boric Acid (Prescription 54). It acts mild- 
est. To prepare it, dissolve four heaping tea- 
spoonfuls in a quart of boiling water. The undis- 
solved powder settles down to the bottom of the 
vessel while cooling. The clear solution is ready 
for use. 

Prescription 54. 

Boric Acid 3 ounces 

Four heaping teaspoonfuls to a quart of 
boiling water. 

Potassium Permanganate (Prescription 55), 
in the strength of from 1 :8000 to 1 :3000. It is 
prepared by dissolving two to six one grain tablets 
in a quart of boiled water. It is more antiseptic, 
but also more irritating. 

Prescription 55. 

Potassium Permanganate 

1 grain tablets, No. 100 

Reduce to powder and dissolve in hot water. 

Silver Nitrate (Prescription 56). This remedy 
often acts very satisfactorily. It is, however, 
still more irritating than Potassium Permangan- 
ate and should only in exceptional cases be used in 
stronger solution than from one half to two grains 
to the quart of water. If at any time the pain 
increases, or the urine grows more cloudy, the 
strength of the remedy should at once be reduced. 



BY DR. FERDINAND HERB. 169 

Prescription 56. 

Silver Nitrate 16 grains 

Distilled Water 16 ounces 

One-half to two ounces to a quart of 
water. 

Formaldehyde (Prescription 57), in the 
strength of from fifteen to thirty drops to the 
quart of water. It is of advantage in cases where 
the urine is full of pus and smells foul. It is 
easily prepared and not staining. 

Prescription 57. 

Solution of Formaldehyde 1 ounce 

Fifteen to thirty drops to a quart of water. 

As to the choice of remedy, we think it best 
to begin with Boric Acid and gradually take the 
others as improvement proceeds. 

The water for the solution should always be 
freshly boiled and the medicine be used as hot as 
possible. The best results are obtained in this 
way. 

Weak solutions must be used first and the 
strength of the remedy be increased as conditions 
demand. Each rinsing should be continued until 
the fluid returns clean. It can be repeated once 
or twice a day or every other or third day as 
seems warranted. 



170 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXVIH. 



INFLAMMATION OF THE KIDNEYS. 

We need not dwell at great length npon this 
disease as it is beyond the scope of this book. But 
we feel it incumbent upon us to briefly mention it : 

First, because it is a complication of gonor- 
rhea frequently met with, if the gonococcus suc- 
ceeds in ascending from the bladder to the kidneys. 

Second, because the indiscriminate use of bal- 
samic remedies may also cause it. Not unless 
he knows about a threatened danger, can a patient 
guard against it. 

Though very valuable, if used at the right 
time and in proper quantity, balsamic remedies 
should always be resorted to with great caution. 
Whether they are taken as one 's own choice, or as 
patent medicines, or on the doctor's prescription, 
the patient should always watch his kidneys while 
using them, unless this is done for him by his 
physician. The slightest irritation of these 
organs, indicated by the appearance of albumen 
in the urine, gives the warning sign to immediately 
stop these remedies. 

Although pains in the back may occasionally 
signal the approaching danger, they cannot be 



BY DR. FERDINAND HERB. 171 

relied upon. The severest inflammation of the 
kidneys can exist without the slightest annoy- 
ance. A simple test will give the necessary in- 
formation. It all depends on the presence or 
absence of albumen in the urine. If it is present, 
the kidneys are diseased, if it is absent, they are 
not diseased. 

How to make this test is described in the last 
chapter of this book. 



172 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XIX. 



GONORRHEAL RHEUMATISM. 

As stated in Chapter 4, the gonococcus may 
occasionally enter the circulation and, carried 
away with the blood, settle in any part of the 
body. Inflammation ensnes at the place of its 
lodgment. Thns the joints are frequently in- 
volved. The reason why the pnblic knows so 
little about this serious complication lies in the 
fact that under such circumstances but few physi- 
cians make the right diagnosis. They call the 
disease "Rheumatism" and let it go at that. 

We must admit that it is very easy to con- 
found the ' ' gonorrheal ' ' with the genuine rheuma- 
tism, as they look so much alike. But there are 
points of distinction. The genuine rheumatism 
usually affects a number of joints, jumps from one 
place to another, and yields readily to treatment ; 
the gonorrheal rheumatism, however, mostly — not 
always — attacks only one or two joints, princi- 
pally the knees, rarely wanders about, and last, 
but not least,— is very obstinate and unamenable 
to treatment. 

If, therefore, a patient, male or female, suf- 
fers from "rheumatism" which obstinately re- 



BY DR. FERDINAND HERB. 173 

mains in one or two joints, renders the affected 
parts extremely painful and is very resistant to 
treatment, we advise him or her to consider the 
possibility of a gonorrheal affection. 

The gonorrheal inflammation of the joints is 
so frequent that we venture to assert that very 
many of those afflicted with stiffened knees, arms, 
etc., perhaps the majority of them, must blame the 
gonococcus for their crippled condition. Of 
course, the connection between the specific germ 
and the deformity is not always plain, especially 
to the layman. But the more the hidden roads are 
known by which it wanders, the more its treacher- 
ous ways are understood, the more cases will, by 
diligent search, be justly placed at the door of this 
insidious microbe. 

It matters not whether the case is ! acute or 
chronic, whether the discharge is plenty, thick and 
creamy, or slight and scanty, or even only in the 
shape of filaments and shreds, the joints are 
threatened so long as gonococci remain in the 
urinary tract. Though the " little dose" may have 
been forgotten; or, as 1 with women and children, 
the existing discharge never has been known to be 
specific,— that does not alter the case. As with 
the testicles, so with the joints. Their swelling 
may surprise the patient at a time and under cir- 
cumstances so remote and disconnected that only 
the well informed will suspect the underlying 
cause. 

The following case, witnessed by the author, 
is well worth mentioning at this juncture. 

A young man of powerful physique entered 
the University Hospital in Munich, Germany, on 



174 GONORRHEA AND SEXUAL DEBILITY 

account of pains in the region of the heart and 
shortness of breath upon slight exertion. Ex- 
amination revealed an affection of the valves of 
the heart. No other pathological process could 
be detected. The case seemed rather obscure 
until, a few days later, the left knee began to 
swell and the secretion taken from the joint re- 
vealed numerous gonococci. No discharge could 
be squeezed from the urethra. Its outlet seemed 
perfectly normal, but plenty of gonococci were 
present in the few lonely shreds contained in the 
first drops of urine. 

Upon questioning, it was ascertained that 
the patient contracted gonorrhea about a year 
before. He cured himself in a few weeks by tak- 
ing Copaiba and felt perfectly well until the 
present ailment began. 

The case developed into a very serious one. 
After a long and painful illness he left the hospi- 
tal with a stiffened knee, a ruined heart, a cripple 
for life. 

INFLAMMATION OF THE HEART, 
THE MUSCLES, ETC. 

These complications of gonorrhea are men- 
tioned here only to complete the sketch. They 
are very rare but serious afflictions and adduce 
further evidence that the "little dose" is not so 
contemptible after all and looms up rather as a 
giant of giants among the scourges that curse the 
human race. 



PART II. 



SEXUAL DEBILITY. 



BY DR. FERDINAND HERB. 177 



CHAPTER XXX. 



SELF-ABUSE OR MASTURBATION. 

By " Self -abuse or Masturbation" is under- 
stood an unnatural sexual satisfaction obtained by 
the manipulation of one's own body independent 
of the opposite sex. 

The "vice" is enormously prevalent and is 
known to have been practised from the earliest 
infancy up to old age. 

Masturbation in Infancy. — Although the 
cases of self -abuse in infancy and early childhood 
reported in medical literature are few and far 
between, well authenticated instances are on 
record of infants who managed to satisfy their 
sexual instincts by rubbing the genitals against 
tightly fitting clothes or between crossed thighs. 

Masturbation in Later Childhood and Youth. 
— The frequency of masturbation increases with 
the advancing years. The number of school chil- 
dren indulging in this immorality is amazing. 
Boarding schools are nurseries for this pernicious 
habit. Once introduced, it spreads like wild fire. 
Although, according to reliable statistics, boys 
surrender more freely to this passion, girls also, 
in great numbers, pay homage to this queen of 
voluptuous sins. 



178 GONORRHEA AND SEXUAL DEBILITY 

Masturbation in Adult Life. — The frequency 
of masturbation decreases as adult life is reached. 
This is due in part because conscience becomes 
aroused either through books or other reading 
matter, or the actual manifestations of disastrous 
consequences; also in part because in many in- 
stances the marriage relation affords opportunity 
to satisfy the sexual cravings in a natural way. 

By no means, however, does the normal satis- 
faction put a stop to abuse. Many a married 
man, father of a large family, cannot gather suf- 
ficient strength of purpose to lift himself out of 
that immoral pit of "youthful error,' ' in spite of 
the highest respect for wife and children 

Causes.— They are manifold. Masturbation 
is rarely the result of an inherited instinct. The 
bad example of friends and playmates, and less 
often the teachings of depraved older children 
and adults, present the original cause. The read- 
ing of libidinous books and the viewing of indecent 
and voluptuous pictures may also give the first 
incentive. 

Further causes are: Irritation of the head 
of the penis caused by the accumulation and de- 
composition of the secretion under the foreskin, 
by pinworms leaving the rectum at night, a too 
narrow foreskin, too tight clothing, itching skin 
eruptions on and around the genitals, etc. Al- 
though they are comparatively rare, they have 
been enumerated to give a possible clue to parents 
and teachers, should the contaminating influence 
of other persons be considered out of question. 

Consequences.— Before entering upon the dis- 
cussion of the consequences of masturbation, let 



BY DR. FERDINAND HERB. 179 

us try to shatter a vision which, for personal gain, 
has been conjured np to create the impression 
that self-abuse must, under all circumstances, 
entail serious consequences. This is not the fact. 
We, certainly, do not intend to minimize the ulti- 
mate effects of an act which is indignantly repudi- 
ated by all those moral and spiritual sentiments 
which elevate mankind above the brute. We can- 
not, however, refrain from strenuously condemn- 
ing the nefarious methods by which unscrupulous 
human hyenas, sailing under the names of ' ' Spec- 
ialists,' ' "Medical Institutes," "Progressive 
Medical Associations," etc., try to benefit by the 
weakness and credulity to which human flesh is 
heir. Their sombre pictures, painted in the most 
vivid colors and representing all the phases from 
physical and mental breakdown to insanity, are 
but the bait to lure "youthful sinners" into their 
well set nets by kindling the arising qualms of con- 
science into the deepest dejection and despond- 
ency. If every young man or woman who satis- 
fies his or her sexual craving by self -manipulation 
were on the high road to perdition and could not 
emerge but with shattered body and soul, what 
would become of human kind? 

Whether any, and how much, damage is done 
depends entirely on the bodily and mental make- 
up of the masturbator. If he is sound as to body 
and mind; if he descends from a sturdy, robust 
stock ; if his previous habits have been good and 
his health not been undermined by the abuse of 
alcohol and tobacco, — a moderate indulgence may, 
perhaps, not entail serious consequences. 

If, however, masturbation is practiced by per- 



180 GONORRHEA AND SEXUAL DEBILITY 

sons whose physical being and nervous system are 
in a wavering and unstable condition; who are of 
weak, nervous, rheumatic or gouty parentage; 
who after slight exertion suffer from exhaustion; 
or who tax their strength by simultaneous abuse 
of alcohol and tobacco, or by too strenuous mental 
labor and worry,— serious consequences are rarely 
wanting. 

The greater the predisposition, the greater 
will be the injury, other things being equal. This 
refers especially to the growing child at the age 
of puberty, a time when in Nature's economy the 
body needs all available support for the develop- 
ment of its organs. The waste of nervous energy, 
which inevitably accompanies the act of mastur- 
bation, is of double significance at this critical 
period. 

But even a strong and healthy body and a 
sound nervous system cannot withstand the drain 
very long if masturbation is practiced excessively. 
Sooner or later the time will come when the scales 
upon which the gain and loss is balanced tip to the 
losing side and the malefactor finds himself en- 
gulfed into that dangerous field of nervous break- 
down which, like quicksand or a bottomless 
swamp, swallows the sinner the sooner, the more 
he struggles; unless, indeed, a steadfast determin- 
ation to desist helps him onto solid ground. 

The bad effects of masturbation usually mani- 
fest themselves first through a feeling of lassitude 
and mental languor. The culprit grows pale, 
loses flesh, cannot apply himself to his work, shuns 
physical exercise, complains of headaches, pres- 
sure on the brain, restlessless, nervousness. His 



BY DR. FERDINAND HERB. 181 



conduct is peevish, depressed and stupid; his sleep 
is disturbed by exhausting dreams and not re- 
freshing. He avoids the company of his former 
playmates. Young people, theretofore upright 
and honest, begin to lie and evade serious ques- 
tioning. Gradually the condition changes from 
bad to worse, as qualms of conscience arise or 
quack literature darkens still more a horizon al- 
ready somber and gloomy. In extreme cases life 
seems wasted. It is impossible to escape the dark 
shadow cast by the seemingly approaching ruin. 
Desperation is at hand. The wreck is almost 
hopeless, and the subject of self -pollution is a 
burden to himself and others, unfit to fill his place 
as a member of the great human family. 

Many other local symptoms accompany this 
general physical and mental breakdown. They 
are especially prominent with reference to the 
genitals. The penis begins to shrink and become 
flaccid. The erections, formerly good and strong, 
grow gradually weaker; the seminal discharges 
thinner and more watery. The irritability of the 
genitals increases often to such an extent that the 
rubbing of tight clothes, fondling of women, or 
even the thought of cohabitation, are sufficient to 
produce an involuntary discharge with a feeble or 
no erection. 

On account of the hypersensitiveness of the 
urethral canal, urination becomes painful and 
gives rise to the impression that the urine is too 
hot. Frequently strictures develop, night emis- 
sions, or wet dreams, multiply; seminal losses at 
stool or while passing water begin and increase by 
their baneful influence on mind and bodv the al- 



182 GONORRHEA AND SEXUAL DEBILITY 

ready augmented difficulties. 

That grave constitutional diseases, such as 
consumption, epilesy and insanity, are also the di- 
rect consequences of masturbation, may be ques- 
tioned. It can, however, be easily understood 
that those who are predisposed by inheritance or 
other circumstances, more readily fall victim to 
these diseases if their vitality is sapped by the 
vicious habit. 

Treatment,— In order to remove the ill-effects 
it is, first and above all, necessary to stop the 
filthy habit. If it be the parents who read these 
lines, let them understand that it is necessary to 
be open and frank with their offspring and to 
thoroughly explain to him or her the vieiousness 
of the act in kind and friendly words. This, how- 
ever, should be done without destroying the hope 
of restoration. If the masturbator himself seeks 
this information, be it his consolation to learn 
that those stories of permanently ruined life, pro- 
mulgated by unscrupulous quacks, are not true, 
and that there is hope in store for future health 
and happiness even for those who seem to be 
doomed to inevitable ruin. A good strong resolu- 
tion to desist, strengthened by a hopeful spirit, 
will go far in overcoming the already developed 
consequences. 

But how to conquer masturbation? The task 
is not easy! Sailing is smoothest in such in- 
stances in which a physical cause for the trouble 
can be found, as, for instance, in the case of pin- 
worms, too narrow foreskin, irritation or inflam- 
mation under the foreskin, stone in the bladder, 
accumulation of feces in the rectum on account of 



BY DR. FERDINAND HERB. 183 



constipation, etc. Whatever is found to be the 
cause must be removed and the child admonished 
to resist. Without the necessary information, of 
course, this cannot be accomplished. All foolish 
prudery must be cast aside and some good plain 
heart to heart talk indulged in. 

This course often suffices to bring about 
happy results. If not, it becomes necessary to re- 
sort to coercive measures. These are also re- 
quired in cases where adults unconsciously, while 
sleeping, perform the act. Tying up the hands, 
enclosing the genitals in tight underwear, even 
caging of the penis, has been resorted to. Human 
ingenuity is great and these suggestions may suf- 
fice to stimulate our readers to find their own con- 
trivance, best suited to the special case. 

Evil consequences must be treated as they 
arise. 

Special stress should be laid upon the im- 
provement of the physical and mental condition 
in general, as it exerts a great influence upon the 
betterment of local conditions. 

Plenty of fresh air and outside exercise are 
of good service. They improve the blood and 
divert and cheer the mind. Such sports, however, 
as tend to produce an irritation of the genitals 
should be abstained from. Among these may be 
mentioned bicycling, horse back riding, etc. 

Bathing the genitals and their surroundings 
with cold water, morning and night, or only upon 
rising, has usually a wholesome influence; but 
there are cases where hot applications give better 
results. 

The nourishment should be light and easily 



184 GONORRHEA AND SEXUAL DEBILITY 

digestible, but in plenty. Cooked fruit is of spe- 
cial service, as it moves the bowels. Stimulants 
of all sorts must be avoided, such as coffee, strong 
tea, beer, wine, whisky, brandy, etc. 

Of medicines two kinds are of special value. 
First those which build up the body, and, second, 
those which quiet and soothe the irritated nerves. 

The long list of the first class is headed by 
Iro-Tonic (Prescription 58). It contains a great 
quantity of nourishment, plenty of Iron for the 
formation of blood and Phosphorus for the 
restoration of the nervous system. Besides it is a 
splendid appetizer. 

Prescription 58. 

Iro-Tonic Original Package 

One to two tablespoonfuls three times a 
day before meals. 

Less effective is the Elixir of Iron, Quinine 
and Strychnine (Prescription 59). 

Prescription 59. 

Elixir of Iron, Quinine and Strychnine Phos- 
phates (U. S. P.) 4 ounces 

One teaspoonful three times a day after 

meals. 

Syrup of Hypophosphites (Prescription 60) 
is also frequently prescribed. 

Prescription 60. 

Syrup of Hypophophites 4 ounces 

One teaspoonful three times a day after 
meals. 

The best remedy of the second class is a com- 
bination of Bromides, in the proportions given in 
Prescription 61. 



BY DR. FERDINAND HERB. 185 

However, when taken for a long time, these 
latter sometimes cause a very itchy skin eruption. 
This is harmless and disappears as soon as the 
remedy is discontinued. 

Prescription 61. 

Potassium Bromide, 

Sodium Bromide, each 1 ounce 

Ammonium Bromide y 2 ounce 

Syrup of Orange, enough to make. .4 ounces 
One-half to one teaspoonful three times a 
day. 

For sleeplessness, caused by restlessness and 
not by pain, the Bromides will usually also do. 
If not, they should be combined with Chloral 
Hydrate (Prescription 62). 

Prescription 62. 

Hydrated Chloral 3 drachms 

Potassium Bromide, 

Sodium Bromide, each 1 % drachms 

Ammonium Bromide % drachm 

Syrup of Orange, enough to make 4 ounces 
One tablespoonful in a glassful of water at 
bedtime. 

This remedy gives the best satisfaction, must, 
however, be abstained from by persons who suffer 
from heart disease, as the result of preceding 
Rheumatism or La Grippe. 

Trional (Prescription 63) is milder, but also 
less effective. 

Prescription 63. 

Trional 16 (to 32) grains 

Take at bedtime with a swallow of warm 
water. 

Special chapters have been devoted to ' i Sem- 
inal Losses," "Impotence," "Strictures," etc. 
To these we refer for information as to their 
treatment in order to avoid repetition. 



186 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXXI. 



WITHDRAWAL AND PROTRACTED COITION AND 
THEIR CONSEQUENCES. 

By " Withdrawal' ' is understood the perform- 
ance of the conjugal act in such a manner that the 
penis is withdrawn from the vagina before the 
semen is discharged. 

By "Protracted Coition" is understood the 
holding back of the seminal discharge, which, how- 
ever, is finally emitted into the vagina. 

As with other unnatural acts, if indulged in 
habitually and persistently, these practices cannot 
but entail evil consequences. 

Consequences to Men. — A feeling of fullness 
and weight in front of the rectum usually appears 
first. With this comes a desire to urinate fre- 
quently and speedily. It seems impossible to hold 
the water for any length of time. The stream be- 
comes weak, the urine begins to smart. Dull, 
heavy sensations in and around the rectum, the 
legs, the abdomen, the back, etc., appear, and, if 
the practice is persisted in, all those symptoms 
gradually develop which have been enumerated 
in the previous chapter. It is true, the serious 
physical and mental breakdown caused by exces- 



BY DR. FERDINAND HERB. 187 

sive masturbation is rarely, if ever, reached; but 
the minor ills incident to this filthy habit seldom 
remain absent if withdrawal is continued. 

With the advance of other symptoms, the 
virile power begins to fail. Erections become 
flabby and of short duration. The emissions are 
precipitated to the growing disgust of both par- 
ties concerned. A loss of semen with stool and 
during urination is also frequently encountered. 
The sexual appetite may be, but is usually not, 
impaired. In the beginning it is in some instances 
even increased to such an extent that desire is 
aroused at the slightest provocation, although the 
increasing flabbiness of the organ puts gratifica- 
tion beyond the pale of possibility. 

As many of our readers may be curious to 
know why it is so important that the semen should 
be deposited within the vagina, an explanation 
will not be amiss. 

It would, indeed, make no difference where 
the discharge occurs, were it not for the fact that 
emission is not nearly as complete and relaxing if 
it takes place outside the vagina. In conse- 
quence, the seminal organs are only partly re- 
lieved of their contents and remain congested. 
Their surroundings participate in this engorge- 
ment. The entire body reacts, and the complete 
relaxation and gratification, as after the normal 
act, is absent. 

This very congestion, which fills the deeper 
parts of the urethra and its neighboring organs 
with stagnating blood, causes the dull feeling. It 
is of longer and longer duration, the oftener it oc- 
curs and finally becomes chronic. Inflammation 



1 88 GONORRHEA AND SEXUAL DEBILITY 

ensues and conditions develop similar to those 
caused by masturbation, a fact which accounts for 
the similiarity of the symptoms. 

Consequences to Women. — With women, con- 
ditions differ. They may, or may not, be affected 
by withdrawal. The explanation is this: The 
excitement caused by the act of copulation makes 
the blood rush to the sexual organs. Womb, Fal- 
lopian tubes, ovaries and ligaments become 
swelled and turgid during the act. The moment 
the woman "spends," the nervous strain is re- 
lieved, the blood recedes, the turgescence vanishes 
and the female organs feel at ease. 

If at any time this tide is interrupted and the 
flow staid before it reaches its culmination at the 
moment of ' ' spending, ' ' the relaxation is slow and 
incomplete. The genitals remain congested and 
it may take hours, perhaps days, before the nor- 
mal condition is re-established. 

No bad consequences to the woman follow 
withdrawal: 

First, if the woman is frigid, that is, of cold, 
non-passionate nature — and very many are — and 
is sexually unresponsive. Then, no blood rushes 
to the genitals, none, therefore, need leave them. 

Second, if the woman * ' spends ' ' satisfactorily 
and the congestion, above referred to, is imme- 
diately relieved. 

However, if, on account of withdrawal or too 
quick emission or any other reason, full satisfac- 
tion is withheld from the woman and a congested 
condition of the genitals remains, injurious conse- 
quences are inevitable. The dissatisfaction and 
quickly passing uneasiness, experienced at first, 



BY DR. FERDINAND HERB. 189 

soon turn into a continued feeling of heaviness 
and discomfort in the lower part of the abdomen. 
The oftener the unnatural act is performed, the 
more pronounced will the abnormal condition be- 
come and the longer will it last. Urination be- 
comes frequent, whites appear, the monthly- 
periods grow irregular, the bleeding profuse. 
There ensue bearing down feeling; pains in the 
back, legs and sides; weakness; nervousness; 
sleeplessness; and that train of ailments peculiar 
to women which so often seriously disturbs the 
happiness of the family. 

It must, however, be understood that this 
state of chronic congestion of the female sexual 
organs is by no means always brought about by 
withdrawal alone. There are many other causes. 
But withdrawal being one of them, and a frequent 
one at that, we deem it wise to here call attention 
to the fact. It will, in many instances, undoubt- 
edly, give an unsuspected clue and explain why 
so many women grow worse instead of better in 
spite of continued medical treatment. No wonder 
that no progress can be made under such circum- 
stances, as the unnatural act, if frequently repeat- 
ed, will undermine the health more rapidly than 
medical skill can build it up. 

Treatment.— To stop withdrawal is the first 
and most essential step. If this be done and the 
sexual relations are for a while restricted as much 
as possible, slighter disturbances will disappear 
without further attention. 

As to more serious consequences, we refer to 
the foregoing chapter. The treatment outlined 
there, will be effective here also. 



190 GONORRHEA AND SEXUAL DEBILITr 



CHAPTER XXXTI. 



LOSS OF SEMEN. 



Loss of semen during sleep occurs periodical- 
ly in perfectly healthy men. It is accompanied by 
erections and erotic dreams and followed by a feel- 
ing of satisfaction and relief. The frequency 
varies with different individuals, but an emission 
once or twice a month, probably, represents the 
average. 

Thus far we are within the normal limits. If, 
however, the losses become frequent, that is, more 
than once or twice a week; if they are followed by 
a feeling of distress and continued lassitude; if 
they occur without erotic dreams or with weak or 
no erections ; if they take place during the day or 
when the bowels move or the urine is passed, — we 
are beyond the normal and in the realm of disease. 

An irritation or inflammation in or around the 
deeper parts of the urethra, or a shattered nervous 
system, are the underlying causes. 

These arise : 

First, from self-abuse. This vice deserves 
the first and most prominent place. We have 
dwelt upon it at some length in an earlier chapter 
and will here only reiterate and emphasize the 



BY DR. FERDINAND HERB. 191 

fact that frequent losses of semen by day and by 
night, with or without erections, are conspicuous 
among the great variety of physical and mental 
disturbances following in its wake. 

Second, from too frequent or protracted co- 
habitation or withdrawal. It is a matter of com- 
mon knowledge that over-indulgence in the sweet 
pleasures of love has brought, and will continue to 
bring, ruin upon many an insatiable man. It is 
less known, but true nevertheless, that protracted 
cohabitation or withdrawal very often also leads 
to the same result. In both instances, abnormal 
loss of semen is by no means the first evil symp- 
tom, though it rarely fails to present itself in the 
course of time. 

Third, from chronic gonorrhea and strictures. 
They are another frequent cause in consequence of 
the chronic irritation produced in the deeper parts 
of the urethra. 

Fourth, from irritation of the sexual organs 
in consequence of an unclean or inflamed condition 
of the head of the penis, or of a too narrow or 
otherwise troublesome foreskin. 

Fifth, from irritation of the urethra caused by 
diseases of the rectum, such as piles, fissures, 
polypi; by pin and tape worms; by constipation; 
by excessive bicycle and horse back riding, etc. 

Sixth, from nervous shocks, such as from ex- 
treme fright, joy, chagrin, etc. 

Seventh, from stimulants. The effect of 
alcohol is most pronounced. Even when used in 
moderation it may induce emissions in fairly nor- 
mal men. If, however, indulged in excessively, or 
even moderately by men predisposed for other 



192 GONORRHEA AND SEXUAL DEBILITY 

reasons, the losses may become very frequent. 
Coffee and tea are less injurious, but may, at 
times, strike the finishing blow. 

Symptoms. —There are two varieties of sem- 
inal losses: 

First, the semen is discharged during the act 
of defecation or urination without any sexual sen- 
sation whatsoever. A person may not be aware 
of this abnormal condition until some day he is 
surprised to see some thick, sticky substance, re- 
sembling well cooked tapioca in appearance, ooz- 
ing from the urethra at the end of urination or 
while sitting at stool. 

Constipation usually furnishes the first im- 
pulse. The hard masses of feces press out the 
contents of the seminal vesicles. Later, however, 
as the organs continue to relax, less momentum is 
required. The emissions accompany normal or 
even thin, watery stools, or come at the end of 
urination. Occasionally the discharge precedes 
the urine. In still later stages even jumping, lift- 
ing, yes, walking, may occasion the seminal loss. 
Without stool or urination, more or less moisture, 
containing spermatozoa, appears at the outlet of 
the urethra upon such occasions. 

The semen gradually changes its appearance 
during the course of the disease. It loses its 
thick, sticky consistency and grows thinner and 
more transparent. A miscroscopical examination 
reveals a still greater change. The spermatozoa, 
normally present in great number, well developed 
and lively in their movements, become gradually 
scarcer, begin to degenerate and look unfinished 
and lifeless. 



BY DR. FERDINAND HERB. 193 

The genitals need not be and, indeed, are not, 
changed in the beginning. Nor is the sexual 
power always decreased. As an illustration may 
be cited the case of a traveling salesman who con- 
sulted us on account of severe seminal losses at 
stool. They occurred almost daily while away 
from home. But in spite of this fact he never 
failed,upon his return, to give his wife a very sat- 
isfactory welcome. 

The same is true of the general symptoms. A 
goodly number of those who are troubled with 
seminal losses of this form feel perfectly well. 
Others do not and suffer in various degrees, rang- 
ing from slight annoyances to rather severe types 
of nervous breakdown. The difference depends 
upon the underlying cause, that is, the existence 
of strictures, chronic gonorrhea, etc., and the pres- 
ence of complications. 

Second, the semen is emitted at special occa- 
sions during the night or day. The discharges are 
called "nocturnal or diurnal pollutions" accord- 
ing to the time of their occurrence. 

This form usually begins with increased night 
emissions. At first, voluntary dreams and good 
erections accompany the losses. By degrees, 
these, however, fade away. With a vague or no 
pleasurable feeling whatever the semen flows from 
the flaccid organ, and the only evidence of the by- 
gone drama is a spotted night shirt or a besmeared 
skin. As the case progresses, losses during the 
day aggravate the condition. The embrace of a 
girl during dancing, a handshake, yes, the very 
presence of an attractive female, may suffice to 
provoke the emission. 



194 GONORRHEA AND SEXUAL DEBILITY 

The condition of the erections varies greatly. 
While in some instances they remain normal in 
spite of frequent pollutions, in the majority they 
soon begin to fail. The catastrophe may also be 
initiated by the failure of the erections. Gradual- 
ly the emissions become precipitated, the flabbi- 
ness increases, the testicles hang low and appear 
soft and withered, the penis shrinks and its irrita- 
bility and sensitiveness increase. To these symp- 
toms may be added: Radiating pains in the sper- 
matic cords, the groins and the bladder; further- 
more lame back, pains in the stomach, loss of ap- 
petite, nervous dyspepsia, weakness, nervousness, 
palpitation of the heart, irritability, sleeplessness, 
dejection and despondency, etc. 

It hardly ever happens that all symptoms are 
present at the same time. They develop now in 
this and then in that direction and, combining and 
grouping in different ways according to their 
basic cause, form ever-changing, kaleidoscopic 
pictures. 

Treatment.— It is evident that a rational 
treatment of seminal losses cannot be given by lay- 
ing down cut and dried rules. Causes and symp- 
toms are so manifold that nothing but general out- 
lines can do justice to all. One point, however, 
must be brought out emphatically and that is that 
the battle is more than half won if a local cause 
of the trouble can be detected and removed. 

Therefore, everyone who suffers from seminal 
losses should first of all make an earnest effort to 
get at the root of the evil. It has been laid bare in 
its principal ramification in the foregoing pages. 
Eradicate it, if possible! Stop bad habits; bridle 



BY DR. FERDINAND HERB. 195 

your passions; cure chronic gonorrhea or stric- 
tures, if present; see that piles or other disorders 
of the rectum or foreskin are attended to ; regulate 
the bowels and lead a moderate and healthful life ! 

The observation of this fundamental rule will, 
in light cases, very often be sufficient to bring 
about a perfect cure. Nothing is more harmful 
than to worry over, and become frightened at, an 
occasional seminal loss. If it does not occur 
oftener than once or twice a week, it requires no 
further attention, provided that no weakness or 
nervousness follow. To dwell or brood upon the 
matter unduly will usually lead from bad to worse 
and in consequence of the nervous strain increase 
the number and ill-effects of the emissions. A 
cheerful and hopeful state of mind is as great an 
ally in the treatment of sexual affairs as a gloomy 
and depressed spirit is a serious hindrance. The 
somber pictures portrayed in the advertisements 
of quacks are grossly overdrawn and tend to 
greatly aggravate the untoward condition. 
Beware of them and similar literature. 

Exercise. — Violent exercise and over-exertion 
of the body are harmful. Among these may be 
mentioned: Long walks, jolting drives over 
rough roads, running, dancing, jumping, foot and 
baseball playing and, above all, bicycle and horse- 
back riding. 

But too little exercise and lack of fresh air 
are also harmful. Therefore, don't sit or lie 
around all day brooding over the discharges. 
Take a walk or walks, short at first, but increasing 
in length as may prove beneficial. A distance of 
from two to five miles a day may be covered if it 



196 GONORRHEA AND SEXUAL DEBILITY 

be broken by intervals of rest sufficiently long to 
avoid fatigue. The open air and the company of 
other people divert the mind into other channels 
and cause one to forget one's own affairs. A 
change of climate, a sojourn in the country or on 
the sea shore sometimes work wonders. 

Bathing. — The use of water, either as full 
bath or as local application, is very often of de- 
cided benefit. The temperature, whether low or 
high, cannot always be decided off-hand. The 
general rule applies that a cold bath is preferable 
in all cases which present a lack of tone, a relaxa- 
tion ; a hot bath is more appropriate where irrita- 
bility is excessive and the nervous system highly 
strung. Therefore, cold washings of the genitals 
and their surroundings usually are better in cases 
of seminal losses with stool and urine, while cases 
of precipitated emissions and day and night pol- 
lutions fare better with hot ablutions and hot hip 
and full baths. However, there are frequent ex- 
ceptions. One's own experience soon furnishes 
the best criterion. 

Cold local applications are best taken in the 
morning upon rising, but occasionally also before 
going to bed. They can, without danger, be ap- 
plied daily. Not so with warm or hot procedures. 
Hot hip and full baths, ranging from 80 to 100 de- 
grees F., should always be taken cautiously in the 
beginning. One or two a week are sufficient to 
start with, but their number may be increased as 
seems warranted. An overdose of these " water 
pills" is just as harmful as an overdose of drugs. 

Surf baths or an addition of from one to five 
pounds or more of common sea or barrel salt to the 



BY DR. FERDINAND HERB. 197 

water of an ordinary tub bath, are often of greater 
service than the usual sweet water baths. 

Diet. — No unusual restriction as to diet need 
be imposed in cases of seminal losses at stool and 
urination. The ordinary daily fare will suffice. 

Not so in cases of precipitated emissions and 
pollutions. In these too much meat is of decided 
detriment and the allowance should be cut down 
to a moderate amount once a day at noon. A 
vegetable diet, with plenty of fruit and cereals 
and especially oatmeal, is preferable. Eggs are 
also permissible in moderation. Too highly sea- 
soned and salted dishes are forbidden. 

The last meal should be taken at least three 
to five hours before retiring, as a full stomach 
tends to produce emissions. 

A like rule applies to beverages. No extra- 
ordinary restrictions need be made in cases of 
losses at stool and urination; all stimulants must, 
however, be avoided by those who have pollutions 
and precipitated emissions. Among these are: 
All fluids containing alcohol, that is, wine, beer, 
whisky, brandy, gin, etc. ; and tea and coffee. 

As a full bladder irritates the genitals and is 
likely to produce emissions, a restriction of fluids 
in the evening is advisable. 

Bed.— The bed should not be too soft and the 
covering not too heavy. 

Regularity of the Bowels.— The regularity of 
the bowels is of paramount importance in the 
treatment of both forms of seminal losses. Even 
the slightest constipation should receive attention. 
The accumulation of the refuse matter in the rec- 
tum is injurious in two ways: First, because it 



198 GONORRHEA AND SEXUAL DEBILITY 

results in a chronic congestion of the intestines 
and their surroundings and leads to piles and irri- 
tation of the seminal organs; second, because the 
hard lumps, on their way out, mechanically press 
the semen from the seminal vesicles (see Figure 
29). 

Strong purgatives, especially Aloes, should be 
avoided. They are harmful. It is far better to 
regulate the bowels by moderate exercise and 
proper diet, such as oatmeal, fruit, fresh vege- 
tables, etc., than by drugs. Mild saline laxatives, 
such as Epsom and Rochelle salts, and also Castor 
Oil or Senna Tea, are preferable, if internal reme- 
dies must be resorted to. 

Coition and Marriage. — As said on a former 
page, erections are frequently unimpaired in those 
who suffer from losses at stool and urination. 
Sexual intercourse, enjoyed in moderation, is un- 
der such circumstances not only not harmful, but 
in many instances beneficial. No one should, there- 
fore, hesitate to consider marriage on account of 
these losses, provided that he is otherwise perfect- 
ly well and has fair erections. A well regulated 
marriage relation may even bring about a perma- 
nent cure. 

Not so with those who suffer from precipi- 
tated emissions and pollutions. To seek a cure 
for this anomaly in marriage nearly always proves 
an utter failure. Coition must be abstained from 
in these cases as long as possible. More than 
that! Even sexual excitement of any kind 
should be anxiously forestalled, as nothing short 
of perfect rest of the sexual organs can restore the 
proper function of the sexual nerves. It may be 



BY DR. FERDINAND HERB. 199 

difficult for married men to follow this advice, but 
experience will teach them that the oftener an un- 
successful attempt is made, the worse the condi- 
tions grow. "With a shattered courage and a wan- 
ing hope, sexual power drifts hopelessly on a 
rough and tempestuous sea. 

Suspensory. — The application of a tightly fit- 
ting suspensory is always advisable (see Chap- 
ter 26). 

Irrigations. — Irrigations of the urethra have 
often proved satisfactory in results. This is espe- 
cially true if cold water is used in cases of in- 
creased irritability in the deeper parts of the 
urethra, signified by precipitated emissions and 
day and night pollutions. These irrigations are 
made in precisely the same manner as described 
in Chapter 13, but using cold instead of hot water. 




Figure 31. Rectal coolers. 

The same precautions should be observed and the 
water be freshly boiled and cooled each time. For 
the rectum, another instrument may also be used 
(Figure 31), which cools the parts without dis- 
tending the bowels with water. 

The duration of the treatment should be short 
and the temperature of the water reduced grad- 
ually as the case warrants. It is sufficient to re- 



200 GONORRHEA AND SEXUAL DEBILITY 

peat this procedure daily or every other day. Hot 
irrigations produce better results only in the min- 
ority of these cases. 

Instruments. — Passing a sound is another 
way of allaying the irritation, even in instances 
where no strictures exist, provided that the larg- 
est possible size is selected. Its very touch of the 
sensitive parts is healing. In all cases of stric- 
tures, from the slightest to the tightest, divulsion 
with a dilator (see Chapter 24) is far better. 

Remedies. — Countless remedies have been 
recommended. Few have stood the test. Of 
these, Bromides are most universally used (Pre- 
scription 64). A large dose taken at bedtime pre- 
vents night losses in many instances. 

Prescription 64. 

Potassium Bromide, 

Sodium Bromide, each 1 ounce 

Ammonium Bromide % ounce 

Syrup of Orange, enough to make. .4 ounces 
One to one and a half teaspoonful at bed- 
time. 

The same is true of Antipyrine (Prescription 
65), taken in doses of from ten to twenty grains 
before retiring. 

Prescription 65. 

Antipyrine 1 ounce 

Syrup of Orange, 

Water, each enough to make 4 ounces 

One-half to one teaspoonful at bedtime. 

Both remedies have their disadvantages. Not 
infrequently they fail to benefit and sometimes 
produce by-effects of unpleasant nature. Bro- 
mides, for instance, cause itching skin eruptions 
if taken continuously for an extended time. 



BY DR. FERDINAND HERB. 201 

Morphine and Heroine are also frequently 
prescribed. We advise against these remedies, as 
they are habit-forming drugs. 

In the long run, Iro- Tonic Tablets (Prescrip- 
tion 66) give better and more lasting satisfaction 
than any of the above named remedies. They are 
perfectly harmless, but very effective and have 
rarely disappointed our expectations. 

Prescription 66. 

Iro-Tonic Tablets Original Package 

Three tablets three times a day after meals. 



202 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXXm. 



IMPOTENCE OR LOST MANHOOD 

By "Sexual Impotence" is understood the in- 
ability to perform the act of sexual intercourse. 

Causes.— We will omit from our enumera- 
tion all those instances where copulation is impos- 
sible on account of malformations* and turn our 
attention at once to those cases where the penis 
and the testicles are normally developed and 
coition is interfered with by reason of: 

First, the flabbiness and non-turgescence of 
the organ. 

Second, precipitated emissions. 

Both calamities are usually combined. They 
spring from the same fountain and shall, there- 
fore, be treated together. 

The principal causes are: 

First, over-indulgence in sexual intercourse. 
Any excess is followed by a re-action, proportion- 
ate to the abuse. Nowhere has this axiom proved 
truer than in sexual affairs. Moderation is the 
foundation upon which the future power rests. 
But what is moderation? It cannot be denned in- 
flexibly. It all depends upon the individuality. 
Therefore, the question, put so frequently to the 



BY DR. FERDINAND HERB. 203 

physician: "How often can a man with impunity 
indulge in sexual intercourse V ' cannot be an- 
swered off-hand. It is in sexual affairs as in all 
other things in life, as, for instance, in walking, 
eating, etc. What is moderation for one, is an ex- 
cess for another, and vice versa. There is, how- 
ever, an indicator upon which one can safely rely, 
namely, the personal feeling. It makes no differ- 
ence how often intercourse is practiced, if once a 
month, once a week, or once a day; it is not in- 
jurious so long as a feeling of relief and buoyancy 
follows. If continued lassitude results; if head- 
ache, nervousness, dejection and other abnormal, 
unpleasant feelings ensue,— then, coition is -injur- 
ious, even if practiced only once a month. The 
average, we admit, is considerably higher, and we 
do not consider ourselves far off the mark if we fix 
the normal, safe indulgence for the average, 
healthy married man at from one to three times a 
week. Striking examples of enormous sexual 
energy are on record. One of them is related by 
Professor Fuerbringer, of the University of Ber- 
lin, Germany. He refers as "ein schier unglaub- 
liches Unicum" to the case of a 54 year old gentle- 
man who for years relished the consummation of 
his marital rights twice a day. 

Second, self-abuse, withdrawal and protract- 
ed coition. To these we have referred in previous 
chapters. 

Third, strictures and chronic gonorrhea. We 
have spoken of these ailments at length in prev- 
ious pages and will confine ourselves here to the 
mere mention of them on account of their poten- 
tiality for impotence. Strictures are so frequent- 



204 GONORRHEA AND SEXUAL DEBILITYiJ 

ly the cause that they should be searched for in 
every case of this ailment. 

The following minutes of an interesting case 
are very instructive: Finely developed, sturdy 
laborer, 39 years old, second time married with 
woman of 25. Notices a failing of his virile pow- 
er since one and one-half years. Took first adver- 
tised "Lost Manhood Pills. ,, No benefit! Was 
then treated by a "Medical Institute.' ' No 
benefit! Saw then two physicians, who, without 
examining, prescribed drugs. No benefit! No 
semblance of erection was left when he first 
presented himself. He was downcast, dejected, 
mortified. Although he exhibited no symp- 
toms of urethral trouble, upon examination several 
slight, but painful strictures were found near the 
bladder. These having been removed by dilation, 
the erections gradually returned. 

Fourth, varicocele. In a great majority of 
cases varicocele has no influence whatsoever on 
the virile power of men. We know of a great 
number of instances where persons afflicted with 
large and voluminous varicoceles have perfect 
erections and a sexual capacity which is above the 
average. It can, however, not be denied that in 
some instances erections are impaired by this 
anomaly and can be improved upon by operation. 
It is, therefore, an absurdity to always see in the 
presence of a varicocele sufficient ground for an 
existing impotence, without taking other, more 
frequent causes into consideration. 

Fifth, diabetes. By diabetes is understood a 
constitutional disease in which sugar is excreted 
with the urine. The latter must be examined to 



BY DR. FERDINAND HERB. 205 

detect the disease (see last chapter). Increased 
thirst and passing a great deal of water, say three 
to ten quarts a day, are the most prominent symp- 
toms of this ailment. They may, however, also be 
absent and the diabetes be overlooked by other- 
wise competent physicians. The following case 
may serve as an illustration in point: A young 
student of medicine in one of our American uni- 
versities noticed a gradual impairment of his 
erections. He consulted his professor first. A 
thorough local examination gave no clue. He saw 
two more physicians, also prominent in this spe- 
cialty, with no better result. The fourth doctor, 
finally, took the trouble to examine the urine and, 
finding diabetes, laid bare the cause of the ail- 
ment. 

Sixth, obesity. Not taking into consideration 
the exceptions, we can, generally speaking, take it 
for granted that with the increase of corpulence 
the sexual capacity decreases. In extreme cases 
complete impotence may prevail. If the fat is de- 
creased by exercise and appropriate treatment, 
erections often return. 

Eighth, intoxicants. Of the great variety of 
poisons consumed daily by human beings three, 
principally, interest us here: 

Morphine. Those addicted to this drug 
usually first feel an increase of their sexual power; 
later a decrease is observed, which in most cases 
ends in complete impotence. 

Alcohol. Small quantities of this stimulant 
increase the sexual desire by allowing the animal 
passions to prevail over the higher instincts. Thus 
it frequently happens that men who normally 



206 GONORRHEA AND SEXUAL DEBILITY 

abhor illicit relations fairly plunge into such ad- 
ventures when more or less intoxicated. 

But while the desire is increased, emission is 
usually retarded. It often takes an unusually 
long time before the act is consummated, increas- 
ing the probability of infection, if one be present. 

Large quantities of alcohol, consumed habit- 
ually, make men unfit for copulation. Not only 
do erections fail, but the desire also vanishes; the 
flames of love and sexual passion become extinct. 

Tobacco. It ordinarily has no deleterious 
influence, except when taken immoderately. 

Seventh, kidney disease. In some cases 
Bright 's disease (see last chapter) can undoubted- 
ly be held responsible for the failure of the sexual 
power. But these instances are few and far be- 
tween. We have mentioned them here because 
many of the laity too often place the blame upon 
this ailment. 

Ninth, bicycle and horse back riding. These 
sports also at times exercise an unfavorable influ- 
ence upon the sexual power. The constant jar- 
ring pressure weakens the prostate gland and 
other sexual organs and impairs their function. 
At the outset, speedy relief usually follows the dis- 
continuance of the sport. Persistence in it may, 
however, make sexual gratification a thing of the 
past. 

Tenth, locomotor ataxia. As with diabetes. 
so locomotor ataxia, a disease of the spinal cord, 
often develops the decrease or loss of sexual power 
as one of its earliest manifestations. Additional 
symptoms of this disease are given for identifica- 
tion: Darting pains in the legs; change in the 



BY DR. FERDINAND HERB. 207 



size of the pupils ; inability to walk in the dark or 
with eyes shut; a feeling of numbness, or tingling 
or creeping sensations in hands and feet, giving 
the impression as if they were covered with thick 
stockings or mittens respectively; the feeling as of 
a tight belt around the waist; disturbances of the 
bladder; weakness in the legs; etc. 

Eleventh, sexual neurasthenia. By sexual 
neurasthenia is understood a nervous break-down, 
resting upon a sexual basis. It is contracted by 
too frequent repetition of the normal sexual act, 
excessive masturbation, habitual protraction of 
coition by holding back the emission, habitual 
withdrawal, strictures, chronic gonorrhea, gleet, 
losses of semen at stool and urination, frequent 
wet dreams, etc. 

The loss of virile power will occasionally re- 
sult in any of these instances and the break-down 
be hastened more, the weaker the basis is upon 
which the nervous system and the physical being 
of the affected person rests. 

Twelfth, age. The sexual appetite and 
power begin ordinarily to decrease at about the 
fiftieth year and are entirely extinguished at the 
sixty-fifth to seventieth year. Examples, how- 
ever, are vouched for which go to show that in 
some extraordinary instances the sexual capacity 
continued to flourish up to the eightieth or even 
ninetieth or hundredth year. But only the ex- 
ceptional few are tnus "favored." The gruntling 
complaint of an ebbing tide on the part of some 
old and feeble men with withered bodies, is, there- 
fore, unwarranted. Nature's laws are inexorable. 
As vision or mental and physical elasticity, on the 



208 GONORRHEA AND SEXUAL DEBILITY 

average, decrease with age, so also does the sexual 
power participate in the decline. 

Thirteenth, causes unknown. There is always 
a certain percentage of cases where no cause what- 
soever can be detected. The generative organs 
are perfect, the penis is well developed, the testi- 
cles are hard and solid— and yet, erections are de- 
fective or wanting. These cases are classed as 
"Nervous Impotence," indicating that the fault 
does not lie with the sexual organs but rather with 
those nerve centers in the spinal cord and brain 
that dominate them. 

The total absence of any and all sexual in- 
clination and impulse towards the opposite sex 
must be designated as a freak of Nature rather 
than a disease. This phenomenon is known as 
"Sexual Frigidity." Though very frequent in 
women, it is rarely met with in men. 

Much more frequent than sexual frigidity is 
another strange phenomenon, the so-called "Rela- 
tive Impotence, ' ' that is, the inability to copulate 
with one woman while the virile power is exhuber- 
ant in the intercourse with another. Marriage is, 
unfortunately, very often the cradle of this 
anomaly. This truth is frequently borne out by 
the confessions of men who are utterly neglectful 
of their duties at home, but are vigorous and 
passionate in sexual alliances outside the marital 
fold. The "reason why" remains obscure. It 
is, certainly, not right to simply assume that 
"change makes appetite." Nor can the superi- 
ority of the "other" woman always solve the 
riddle; for the person preferred is very often so 
far below the standard of the legitimate spouse, 



BY DR. FERDINAND HERB. 209 

physically and mentally, that it seems strange, 
indeed, that the sexual taste should go so far 
astray under the impelling force of animal pas- 
sion. But it does. The same mysterious law of 
attraction and repulsion which directs to a large 
extent our other feelings also sways the sexual 
propensities. Whether an exchange of animal 
magnetism is the dominating factor, has never 
as yet been demonstrated; but our view inclines 
in that direction. 

That continence can lead to total loss of virile 
power, has been denied by some and affirmed by 
others. The weight of authority is to the effect 
that it has never injured a healthy man. It can, 
however, not be gainsaid that the sexual impulse 
is ordinarily diminished by continence extended 
over a longer period of time. But this need not 
cause concern! A little practice will, on oppor- 
tunity, soon restore the original vigor. 

Temporary impotence is often experienced 
for some reason or another. Sudden fright, ex- 
treme joy, hard mental or physical labor, etc., 
may, for a while, destroy all sexual passion. The 
equilibrium restored, virility usually returns in 
its former strength. 

So-called " notions' ' frequently impair and 
sometimes even totally destroy the sexual power. 
We must lay stress upon this fact, as the banish- 
ment of the " notion' ' and the restoration of con- 
fidence in one's own ability is often the only pre- 
requisite necessary to a permanent cure. By 
"notion" is here understood the firm but 
erroneous belief that conditions exist which make 
intercourse impossible, as, for instance, a shriv- 



2 JO GONORRHEA AND SEXUAL DEBILITY 

eled penis, hanging testicles, a varicocele, etc. 

A striking case in our own experience may 
serve as an elucidation: 

Mr. M.S., merchant, had practised self-abuse 
in his younger days quite immoderately. Aroused 
by advertisements in the daily press and other 
vicious literature, he gradually became convinced 
that his former vice had made him impotent. He 
resolved to try and failed utterly. Discouraged 
and down-hearted he abstained from further 
attempts until two years later, when an unlooked 
for opportunity presented itself. He tried once 
more. Failure ensued again and also upon several 
following occasions. One day, however, after a 
social function, in which wine and champagne 
were indulged in freely, he visited a "lady friend* ' 
in an exhilarated mood. Forgetful of his former 
fears, he performed the act to his entire satisfac- 
tion. Thus convinced of his usefulness, his 
courage returned. He married and remained 
completely cured. 

Symptoms.— The most conspicuous symptom 
of impotence is the imperfect erection or utter 
absence thereof on the one hand, and the pre- 
cipitated emission on the other. 

A general debility, physical and mental, is 
often associated with the local trouble. In many 
cases it is, however, wanting. 

Treatment.— The treatment of impotence 
must always begin with the removal of the cause, 
if possible. It is of but little value to swallow 
medicines so long as the root of the evil remains 
undisturbed. This dislodged, the task is well in 
hand. 



BY DR. FERDINAND HERB. 211 

Diet. — The diet, in many instances, exercises 
a decided influence upon the sexual organs. Upon 
its selection often depends the success or failure 
of the treatment. 

An ordinary mixed diet, well prepared and 
easily digestible, consisting of meats and vege- 
tables, is usually right. 

A preponderance of meats in the diet is pre- 
ferable for those who suffer from feeble erections 
without frequent emissions and whose sexual 
organs need a stimulus. Meat spurs a sluggish 
circulation, especially if taken raw. It matters 
not where it comes from, whether from domestio 
or wild animals, so long as it is well borne by the 
stomach. 

A number of other foodstuffs enjoy great 
popular prestige as sexual stimulants, namely: 
Eaw eggs, celery, asparagus, raw oysters, etc. 
There is a reason for it, and they deserve a trial 
under such circumstances, though too great reli- 
ance should not be placed upon them. 

A vegetarian diet is preferable in all cases 
where the sexual impairment comes from over- 
stimulation, as in the case of precipitated emis- 
sions or day and night pollutions, the result of 
an increased irritability of the sexual organs or 
of the entire nervous system. The restriction of 
meat is, in such instances, often followed by a 
decided increase of the sexual power. 

The vegetarian diet should be prepared in a 
pleasant, appetizing and easily digestible form. 
Pancackes, fried cakes, fried vegetables, freshly 
baked bread, etc., lie heavily upon the stomach 
and had better be avoided. 



212 GONORRHEA AND SEXUAL DEBILITY 

Leguminous 1 dishes, such as peas, beans and 
lentils, merit special attention. "Well cooked and 
made into soups and purees, they constitute a rich 
and most excellent food for those who must 
abstain from meats. 

The quantity also is of importance. To take 
more food than is required is just as injurious as 
to fast unnecessarily. The weight of the body 
should be kept at the healthy average. Under 
and overweight both tend to diminish the sexual 
power. 

Alcohol — Most authorities agree that alcohol 
in all and every form must be absolutely avoided. 
The daily experience teaches that alcoholic stimu- 
lants, such as beer, wine, gin, ale, whisky, brandy, 
etc., inhibit the sexual function, though, we admit, 
they stimulate the desire by rousing the animal 
passion. 

But there are frequent exceptions to this 
rule. The ingestion of a moderate amount of 
alcohol in a great number of instances has no 
influence whatever upon the sexual organs, neither 
for good nor bad. Sometimes, but more rarely, a 
positive benefit is derived from alcohol, as, for 
example, in such cases where want of self-confi- 
dence, dislike of a particular woman, marital 
indifference, too early emission, etc., present the 
stumbling block and are overcome by benumbing 
or removing that inhibitory influence of the mind 
which makes the act impossible. 

Water. — In the treatment of impotence, hot 
and cold water has given just as favorable results 
as in the treatment of other sexual diseases. 
Many a case of failing power, frequent losses of 



BY DR. FERDINAND HERB. 213 

semen, precipitated emission, etc., will yield to 
this agent far better than to any medicine. We, 
therefore, refer to it with special emphasis. 

The water can be applied either as wash, or 
hip-bath, or urethral irrigation, or rectal douche. 
Their different techniques have been described in 
former chapters, to which we here refer. Eectal 
and urethral applications are of special value. 

Practical experience teaches that cold appli- 
cations are beneficial in more cases than warm 
and hot ones. But we advise to proceed slowly 
and to only gradually descend to ice, or rise to 
hot water, as the benefit becomes apparent. 

Massage. — If no infectious condition exists, 
that is, if there is no discharge from the urethra 
and the trouble not the result and remnant of a 
former gonorrhea, — massage is often of decided 
benefit. It is performed by gently kneading and 
squeezing the testicles, and clapping and hacking 
the inner surface of the thighs and the space be- 
tween the rectum and the pouch of the testicles. 
It should be made once or twice a day and last 
from G.ve to fifteen minutes. 

Intercourse. — Sexual irritation of any sort, 
especially coition, must invariably be abstained 
from until recovery is complete. Eepeated fail- 
ures depress the mind and increase the difficulty. 

Marriage. — This is, indeed, a very tender 
point. It is true, there are numerous cases where 
the regularity and frugality of married life uplifts 
the sunken virile power. But to advise marriage 
would be hazardous, as much depends upon the 
sexual disposition of the wife. To throw himself 
into the arms of an amorous and voluptuous 



214 GONORRHEA AND SEXUAL DEBILITY 

woman is for an impotent more than a mere mis- 
fortune to himself. An unhappy family life, a 
dissatisfied wife, infidelity in marriage, or even 
a scandalous divorce may be the result. 

Medicines. — The less we can rely on drugs, 
the greater is usually the number recommended 
for a disease. So also in this case. Camphor, 
Strychnine, Ergot, Phosphorus, Cocaine, Atro- 
pine, and a host of others have been extolled by 
some, ridiculed by others. The fact is that they 
help in some, fail in other instances. A great 
many of the failures, however, are due, we think, 
not so much to the inertness of the remedy as to 
the neglect to remove the root of the evil. If 
over-indulgence in sexual intercourse, self -abuse, 
withdrawal or protracted coition, are stopped; if 
chronic gonorrhea, strictures, inflammation of the 
prostate gland, etc., are removed; if the abuse of 
alcohol, tobacco, morphine and other poisons, is 
checked at an early date; if a proper diet is se- 
lected, — appropriate remedies in connection with 
the water treatment will prove of great service in 
many instances theretofore intractable. 

Of remedies which are serviceable, Iron, 
Strychnine, Phosphorus and Damiana, are the 
most valuable. These drugs are contained in 
most pills and tablets, sold under the names of 
" Nerve Pills,' ' " Vitalizer," etc., or are prescribed 
by physicians as "Aphrodisiac Pills.' ' These 
latter are ready-made remedies and can be bought 
at any drug store. The formula differs somewhat 
with different manufacturers. "Bheno" Aphro- 
disiac Tablets (Prescription 67) have proved to 
be the most satisfactory. 



BY DR. FERDINAND HERB. 2 1 5 

Iro-Tonic Tablets (Prescription 68) also give 
very satisfactory results, especially if supported 
by the raw yolk of an egg two or three times a 
day, the yolk to be taken before and the tablets 
after meals. 

Prescription 67. 

"Rheno" Aphrodisiac Tablets . . Original Package 
One tablet three times a day after meals. 

Prescription 68. 

Iro-Tonic Tablets Original Package 

Three tablets three times a day after meals. 



216 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXXIV. 



STERILITY. 



By the term "Sterility" is meant the inabil- 
ity to procreate, that is 3 to beget children. The 
ability to copulate may be perfectly normal and 
yet men may be sterile, as we will see later. 
Sterility is, therefore, not identical with impo- 
tence, that is, the inability to copulate, and should 
not be confounded with it. 

Sterility in Marriage. — Childlessness in mar- 
riage is one of the curses imposed upon human- 
ity. It is, we admit, voluntary in some cases, in 
the great majority of instances, however, a most 
unwelcome state of affairs. A home without 
children cannot satisfy a noble, loving woman. 
She naturally seeks motherhood. The desire for 
offspring is so deeply implanted in the human 
heart that the denial of this marital satisfaction 
is frequently a source of profound unhappiness 
and dissatisfaction. So strong is this natural 
desire that no sacrifice seems too great to satisfy 
it, and many a woman gladly submits to long and 
painful medical treatment, or even operations, if 
but a semblance of hope brightens the horizon of 
prospect. 



BY DR. FERDINAND HERB. 217 

Percentage of Sterile Marriages. — We have 
touched upon this subject in Chapter 7. It was 
stated that about one and one-half million mar- 
riages are childless in the United States; that of 
these about 800,000 owe their calamity in this re- 
gard to the infection with the gonococcus; and 
that in about one of every three instances the 
husband is to blame. 

Of this latter point the public seems to be 
strangely ignorant, and it is, unfortunately, also 
very often overlooked by physicians. Many of 
them, when a woman presents herself for treat- 
ment on account of supposed sterility, will ask no 
question as to the husband. Dilation of the 
vagina, the mouth and neck of the womb, abrasion 
of the mucous membrane of the womb, and many 
other operations are performed daily on women, 
without relief, in instances where the examination 
of the husband would at once prove him to be at 
fault. 

Causes of Sterility.— It is beyond the scope of 
this book to enter more fully into the causes of 
sterility in women. They have been touched upon 
elsewhere in this book. The causes of sterility in 
men are here of interest. 

Two different conditions may prevail: 

First, the semen does not reach its destina- 
tion, that is, the vagina, either because emission 
occurs before entrance is gained, or because the 
flabbiness of the organ makes intromission im- 
possible. 

Details as to these conditions can be found 
in the chapter on - ' Impotence. ' ' 

Second, erections may be sufficient and intro- 



218 GONORRHEA AND SEXUAL DEBILITY 

mission possible, but impregnation is impossible 
either because no semen is discharged, or it is dis- 
charged improperly, or because the semen is 
devoid of that fertilizing principle, called 
" Spermatozoa. ' ' 

(a) No seminal fluid. Cases where there 
is no discharge at all during coition are rare, but 
occur occasionally in consequence of malformation 
or inflammation of, or tumors in, the sexual 
organs or on account of other local or systemic 
diseases. 

(b) The semen is discharged improperly. 
These cases are rather frequent. For an explana- 
tion we have to refer to the normal process. 
Under healthy conditions the semen is emitted in 
forceful jets, spurting, as it does, against the 
mouth of the womb. This way of spurting is of 
the highest importance in the process of fertiliza- 
tion as it greatly facilitates the reception of the 
spermatozoa safely within the cavity of the womb. 

There are a number of obstacles which may 
interfere with the proper consummation of this 
act. To these belong principally: 

Strictures. — We have referred to strictures 
as the cause of sterility in Chapter 24. They 
obstruct the free flow of semen long before the 
flow of water shows any abnormality. In light 
cases, the semen rather oozes out instead of being 
ejected; in severe cases, the discharge may be 
retained entirely and instead of flowing into the 
vagina be forced back into the bladder and appear 
in the urine. 

Numerous cases are on record where the cure 
of strictures was followed by a speedy impregna- 



BY DR. FERDINAND HERB. 219 

tion of the wife. 

Displaced Outlet of the Urethra.— It is evi- 
dent that the spurting semen is diverted from its 
regular course if the outlet of the urethra is on 
the upper or lower part of the head of the penis. 
The discharge is, then, thrown against the walls 
of the vagina instead of against the mouth of the 
womb. Thus, the chances for the fertilizing ele- 
ments to reach their natural destination are ma- 
terially decreased, as their path is beset with 
many dangers before they are secured within the 
walls of the womb. 

Too Narrow Foreskin. — Its effect may be 
twofold, either preventing a proper emission, 
or diverting the semen from its proper course. 

(c) The semen is devoid of the fertilizing 
agency, the "Spermatozoa." 

The semen consists, in the main, of a fluid and 
animalcule-like, microscopically small bodies, 
called "Spermatozoa" (Figure 32). 

These latter are formed in the testicles and en- 
liven the semen in enormous number. One hun- 
dred and twenty millions are, on an average, con- 
tained in one discharge. If placed under the 
microscope, they show a lively locomotion and 
present an extremely interesting picture, resem- 
bling very much that offered by a dense swarm of 
wriggling tadpoles in the corner of a pond. 

One of these hundred and twenty million 
spermatozoa is sufficient to fertilize. Its union 
with the egg, which comes from the ovary of the 
woman, forms the starting point of a new human 
being. 

As these spermatozoa are the only fertilizing 



220 GONORRHEA AND SEXUAL DEBILITY! 

agents, it becomes evident that, where they are 
absent, fertilization is impossible in spite of an 
otherwise apparently perfect act. 

The enormous number of spermatozoa in a 
normal discharge and their lively locomotion, 
where only one is needed for the purpose, bear 




Figure 32. Normal semen as seen under the micro- 
scope., 1 — spermatozoa, normally developed. The other, 
larger bodies are normal constituents of the seminal fluid. 

witness to the fact that their search for the female 
egg must be a difficult task. And it is, indeed. 
The interior of the womb is a vast expanse in com- 
parison with the infinitesimal size of the indi- 
viduals of this great army of swarming harbingers 
of procreation. If, therefore, the number of 
spermatozoa is decreased; or their form is ill- 
developed; or their movement impaired, — the 



BY DR. FERDINAND HERB. 221 

chance of fertilization must, and does, decrease in 
proportion as those anomalies are developed. 
The principal causes for such anomalies are : 
First, gonorrhea. Gonorrheal inflammation 
of the testicles may either destroy their faculty to 
form spermatozoa or, oftener, close with exuda- 
tion the canal of the spermatic cord and, thus, clog 
the way from the testicle to the urethra. If only 




Figure 33. 1 — unripe and degenerated spermatozoa, 
greatly diminished in number. 

one testicle was attacked, the faculty of fertiliza- 
tion is decreased ; if both were involved, it is lost 
in the majority of cases, but not necessarily in all. 
In the face of the enormous prevalence of 
gonorrhea, one cannot wonder at the assertion that 
this disease makes far more sexual cripples, so 
far as procreation is concerned, than all other 



222 



GONORRHEA AND SEXUAL DEBILITY 



diseases combined. We say "as far as procre- 
ation is concerned" advisedly, as the erections 
and the faculty of copulation is very often per- 
fectly normal in spite of the fact that no sperma- 
tozoa are produced. 

Second, sexual excesses, masturbation and 
frequent losses of semen. They are next in im- 
portance. In these instances the spermatozoa are 




Figure 34. Seminal fluid containing pus. 1 — white 
blood corpuscles, that is, pus cells. The spermatozoa are 
malformed and few in number. 

usually not entirely absent, but comparatively few 
in number and malformed, as the continuous drain 
upon the testicles does not allow their product to 
ripen sufficiently. 

Third, alcohol. Drunkards in all walks of 
life, whether they are addicted to beer and cheap 



BY DR. FERDINAND HERB. 



223 



whiskies or to wine and champagne, are fre- 
quently unfruitful in consequence of the deleteri- 
ous influence of alcohol upon the testicles. 

Who is to Blame f — In one of every three in- 
stances sterility in marriage must, as stated above, 
be attributed to the husband. In the light of this 
fact, it becomes indispensable to call both husband 
and wife before the bar of investigation, if counsel 
is desired as to the cause of sterility. And the 
husband should be taken first. To begin with the 




Figure 35. Seminal fluid containing blood. 1 — red 
blood corpuscles. The spermatozoa are malformed and few 
in number. 

woman is utterly wrong. What avails her sacri- 
fice, her heroism, pressed to the limit of human 
endurance, if all that stands between her and her 
goal is the inertness of her husband's semen, the 



224 GONORRHEA AND SEXUAL DEBILITY 

absence of spermatozoa? 

The examination of the husband is a matter 
of little trouble. An inspection of the semen under 
the microscope is all that is required to determine 
once for all and definitely whether or not the male 
organs functionate properly. 

If this be made with the proper precaution 
and demonstrates that plenty of well developed, 




Figure 36. Seminal fluid containing no spermatozoa, 
but only the other normal constituents. 

quickly moving spermatozoa are in the semen 
(Figure 32), the procreative capacity of the hus- 
band cannot be doubted, provided the discharge 
is emitted properly. Then, and not until then, is 
the physician justified in looking to the woman 
for the cause of sterility. 

If, however, the spermatozoa are few and far 



BY DR. FERDINAND HERB. 225 

between ; if they are not fully developed and mov- 
ing slowly and lifelessly (Figures 33 to 35), doubt 
as to the man's procreative capacity must arise 
and repeated examinations are required to come 
to a definite conclusion. 

But if no spermatozoa at all (Figure 36) or 
only malformed or dead ones are encountered, 
the procreative capacity is absent, no matter how 
strong the erections or how exuberant and satis- 
factory the power of coition may be. 

Treatment.— The treatment of sterility is 
rather discouraging, except in those instances 
where strictures interfere with the proper emis- 
sion. Very happy results often follow the removal 
of this hindrance. 

In cases of unripeness of the semen, in con- 
sequence of excesses, self-abuse and frequent 
losses, the outlook is also promising, if abuse and 
losses can be stopped. 

But little, very little, can be expected in that 
majority of instances where the semen is devoid 
of spermatozoa because the testicles are ruined or 
their outlets clogged. And yet the proper diag- 
nosis is also here of great importance, as it saves 
blameless women from unnecessary and wholly 
useless torture. 

As to the treatment of sterility in consequence 
of impotence we refer to the foregoing chapter. 



226 GONORRHEA AND SEXUAL DEBILITY 



CHAPTER XXXV. 



EXAMINATION OF URINE. 

We cannot initiate our readers into those 
complicated chemical analyses which are required 
to make expert examinations. This would be im- 
possible and is unnecessary. It will suffice here 
to show how to test the urine for pus, albumen 
and sugar, as these three substances concern him 
mostly. 

The apparatus necessary consists of a test 
tube and an alcohol lamp. Both can be purchased 
at any drug store. 

TEST FOE PUS. 

Take a little urine in a test tube and add a 
few drops of a solution of Caustic Potash (Pre- 
scription 69). If the cloudiness consists of pus, 
the urine gelatinizes, that is, becomes thick and 
sticky ; if there is no pus, it remains thin and fluid. 

Prescription 69. 

Potassium Hydrate 1-3 ounce 

Water 2-3 ounce 

TEST FOE ALBUMEN. 

Fill test tube three quarters full of urine and 
boil upper part as shown in Figure 37. If the 
urine remains clear in the heated portion, no albu- 



BY DR. FERDINAND HERB. 



227 



men is present and the kidneys are not diseased. 
If it becomes milky, add a few drops of strong 
vinegar or any other acid. Should, then, the 
cloudiness remain or grow more pronounced, al- 
bumen is present and the kidneys are diseased; 
if the cloudiness disappears, it has consisted of 
phosphates and does not indicate a disease of the 
kidneys. 




Figure 37. Test of urine for albumen, a — flame. 

Those who take balsamic remedies may 
sometimes find a white precipitation in the heated 
portion which does not disappear upon the addi- 
tion of acid and yet is not albumen. It comes 
from the remedy taken and disappears on the 
addition of alcohol, while albumen will remain 
unchanged. 

TEST FOR SUGAR. 

Take a little urine and add one-tenth of its 
quantity of the solution given in Prescription 70. 



228 



GONORRHEA AND SEXUAL DEBILITY 



Then, shake and boil for three to five minutes 
(Figure 38). If sugar is present, the urine turns 
from dark brown to black according to the amount 
contained therein. In very light cases, the black 




Figure 38. — Test of urine for sugar, a — flame. 

color does not appear until after cooling, when it 
collects at the bottom of the tube as a black 
sediment. 

Prescription 70. 

Dissolve one drachm of Potassium and 
Sodium Tartrate in three and one-half ounces 
of a 10 per cent, solution of Potassium 
Hydrate, slightly warmed, and dissolve in this 
mixture one-half drachm of Bismuth Sub- 
nitrate. Allow to settle. 



Female Diseases 



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